2023
National Institute on Drug Abuse Clinical Trials Network Meeting Report: Advancing Emergency Department Initiation of Buprenorphine for Opioid Use Disorder
Cowan E, Perrone J, Bernstein S, Coupet E, Fiellin D, Hawk K, Herring A, Huntley K, McCormack R, Venkatesh A, D'Onofrio G. National Institute on Drug Abuse Clinical Trials Network Meeting Report: Advancing Emergency Department Initiation of Buprenorphine for Opioid Use Disorder. Annals Of Emergency Medicine 2023, 82: 326-335. PMID: 37178101, PMCID: PMC10524880, DOI: 10.1016/j.annemergmed.2023.03.025.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsOpioid use disorderEmergency departmentUse disordersDrug Abuse Clinical Trials NetworkEffective evidence-based treatmentsEmergency department initiationStandard emergency careMajor public health crisisClinical Trials NetworkEvidence of efficacyNational InstituteEvidence-based treatmentsOpioid overdose deathsTechnology-based interventionsBuprenorphine dosingBuprenorphine initiationPeer-based interventionsPublic health crisisPatient outcomesED staffOverdose deathsEmergency careBuprenorphineTrials NetworkUniversal uptakeConcordance between controlled substance receipt and post-mortem toxicology in opioid-detected overdose deaths: A statewide analysis
Howell B, Black A, Grau L, Lin H, Greene C, Lee H, Heimer R, Hawk K, D'Onofrio G, Fiellin D, Becker W. Concordance between controlled substance receipt and post-mortem toxicology in opioid-detected overdose deaths: A statewide analysis. Drug And Alcohol Dependence 2023, 244: 109788. PMID: 36738634, PMCID: PMC9975083, DOI: 10.1016/j.drugalcdep.2023.109788.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidBenzodiazepinesControlled SubstancesDrug OverdoseHumansOpiate OverdoseUnited StatesConceptsPost-mortem toxicologyOverdose deathsChief Medical ExaminerBenzodiazepine prescribingBenzodiazepine prescriptionsPrimary outcomePreventable deathsOpioid overdosesOpioidsAddiction servicesBenzodiazepinesMental healthStudy periodDeathMedical examinersConcordanceStatewide analysisSubstantial numberReceiptDaysDepartmentMedicationsToxicologyFentanylPrescribing
2022
Association of State Social and Environmental Factors With Rates of Self-injury Mortality and Suicide in the United States
Rockett IRH, Jia H, Ali B, Banerjee A, Connery HS, Nolte KB, Miller T, White FMM, DiGregorio BD, Larkin GL, Stack S, Kõlves K, McHugh RK, Lulla VO, Cossman J, De Leo D, Hendricks B, Nestadt PS, Berry JH, D’Onofrio G, Caine ED. Association of State Social and Environmental Factors With Rates of Self-injury Mortality and Suicide in the United States. JAMA Network Open 2022, 5: e2146591. PMID: 35138401, PMCID: PMC8829661, DOI: 10.1001/jamanetworkopen.2021.46591.Peer-Reviewed Original ResearchConceptsSelf-injury mortalityMAIN OUTCOMEOverdose fatalitiesNon-Hispanic white raceDrug intoxication deathsLeast absolute shrinkageRate ratioCross-sectional studyHealth care accessPublic health policySelf-harm behaviorsAbsolute shrinkageIntoxication deathsWhite raceCare accessInjury mechanismMedical examiner systemEtiologic understandingDeath dataDisease controlUnderlying causeHealth policyDeath investigation processDemographic characteristicsDistrict of ColumbiaAssessing the impact of the Good Samaritan Law in the state of Connecticut: a system dynamics approach
Sabounchi NS, Heckmann R, D’Onofrio G, Walker J, Heimer R. Assessing the impact of the Good Samaritan Law in the state of Connecticut: a system dynamics approach. Health Research Policy And Systems 2022, 20: 5. PMID: 34991591, PMCID: PMC8734429, DOI: 10.1186/s12961-021-00807-w.Peer-Reviewed Original ResearchConceptsOpioid use disorderOverdose deathsGood Samaritan lawsEmergency department visitsOpioid-related deathsPublic health interventionsBehavioral changesPublic health officialsED visitsDepartment visitsOpioid usersUse disordersHealth outcomesOpioid crisisHealth interventionsHealth officialsDeathOverdoseVisitsInterventionOutcomesState of ConnecticutMultiple strategiesPerspectives About Emergency Department Care Encounters Among Adults With Opioid Use Disorder
Hawk K, McCormack R, Edelman EJ, Coupet E, Toledo N, Gauthier P, Rotrosen J, Chawarski M, Martel S, Owens P, Pantalon MV, O’Connor P, Whiteside LK, Cowan E, Richardson LD, Lyons MS, Rothman R, Marsch L, Fiellin DA, D’Onofrio G. Perspectives About Emergency Department Care Encounters Among Adults With Opioid Use Disorder. JAMA Network Open 2022, 5: e2144955. PMID: 35076700, PMCID: PMC8790663, DOI: 10.1001/jamanetworkopen.2021.44955.Peer-Reviewed Original ResearchConceptsUntreated opioid use disorderOpioid use disorderEmergency departmentED visitsOUD treatmentUse disordersPublic safety-net hospitalRural critical access hospitalsEmergency department careSafety-net hospitalUrban academic centerLife-saving treatmentCritical access hospitalsImplementation science frameworkPatient factorsTreatment initiationED careUS patientsStaff trainingDemand treatmentPatient readinessNet hospitalPatient's perspectivePromoting ActionImproved care
2021
Variations in Quality of Care by Sex and Social Determinants of Health Among Younger Adults With Acute Myocardial Infarction in the US and Canada
Raparelli V, Pilote L, Dang B, Behlouli H, Dziura JD, Bueno H, D’Onofrio G, Krumholz HM, Dreyer RP. Variations in Quality of Care by Sex and Social Determinants of Health Among Younger Adults With Acute Myocardial Infarction in the US and Canada. JAMA Network Open 2021, 4: e2128182. PMID: 34668947, PMCID: PMC8529414, DOI: 10.1001/jamanetworkopen.2021.28182.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionQuality of careHealth care systemYoung adultsFemale sexMyocardial infarctionCare systemHospital careSocial determinantsRetrospective cohort analysisLow qualityAdverse SDOHLowest tertileReadmission ratesMore patientsPostacute careAMI careOutpatient careCare scoresHigh prevalenceCohort analysisLarge cohortMAIN OUTCOMESDOHHospitalEmergency medicine research: 2030 strategic goals
Neumar RW, Blomkalns AL, Cairns CB, D’Onofrio G, Kuppermann N, Lewis RJ, Newgard CD, O’Neil B, Rathlev NK, Rothman RE, Wright DW. Emergency medicine research: 2030 strategic goals. Academic Emergency Medicine 2021, 29: 241-251. PMID: 34363718, DOI: 10.1111/acem.14367.Peer-Reviewed Original ResearchMeSH KeywordsBiomedical ResearchEmergency MedicineFaculty, MedicalGoalsHumansNational Institutes of Health (U.S.)United StatesDevelopment and Validation of a Risk Prediction Model for 1‐Year Readmission Among Young Adults Hospitalized for Acute Myocardial Infarction
Dreyer RP, Raparelli V, Tsang SW, D’Onofrio G, Lorenze N, Xie CF, Geda M, Pilote L, Murphy TE. Development and Validation of a Risk Prediction Model for 1‐Year Readmission Among Young Adults Hospitalized for Acute Myocardial Infarction. Journal Of The American Heart Association 2021, 10: e021047. PMID: 34514837, PMCID: PMC8649501, DOI: 10.1161/jaha.121.021047.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPrior acute myocardial infarctionRisk prediction modelMyocardial infarctionYoung adultsDepressive symptomsLonger inpatient lengthPredictors of readmissionFinal risk modelYear of dischargeBetter physical healthAMI severityBackground ReadmissionHospital complicationsVIRGO StudyCause readmissionHospital lengthHospital dischargeYounger patientsDevelopment of interventionsDiabetes mellitusHeart failurePrimary outcomeConclusions WomenMean ageImpact of Race on the In‐Hospital Quality of Care Among Young Adults With Acute Myocardial Infarction
Raparelli V, Benea D, Smith M, Behlouli H, Murphy TE, D’Onofrio G, Pilote L, Dreyer RP. Impact of Race on the In‐Hospital Quality of Care Among Young Adults With Acute Myocardial Infarction. Journal Of The American Heart Association 2021, 10: e021408. PMID: 34431311, PMCID: PMC8649291, DOI: 10.1161/jaha.121.021408.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionCardiac readmissionMyocardial infarctionHospital qualitySocial determinantsYoung adultsWhite individualsBlack individualsSegment elevation myocardial infarctionCardiac risk factorsMultivariable logistic regressionHigh rateWhite US adultsVIRGO StudyBlack raceAMI careRisk factorsCare scoresHigh prevalenceUS adultsReadmissionLogistic regressionInfarctionImpact of raceRacial disparitiesImprove Access to Care for Opioid Use Disorder: A Call to Eliminate the X-Waiver Requirement Now
D'Onofrio G, Melnick ER, Hawk KF. Improve Access to Care for Opioid Use Disorder: A Call to Eliminate the X-Waiver Requirement Now. Annals Of Emergency Medicine 2021, 78: 220-222. PMID: 33966933, PMCID: PMC8324519, DOI: 10.1016/j.annemergmed.2021.03.023.Peer-Reviewed Original ResearchEmergency Department Visits for Nonfatal Opioid Overdose During the COVID-19 Pandemic Across Six US Health Care Systems
Soares WE, Melnick ER, Nath B, D'Onofrio G, Paek H, Skains RM, Walter LA, Casey MF, Napoli A, Hoppe JA, Jeffery MM. Emergency Department Visits for Nonfatal Opioid Overdose During the COVID-19 Pandemic Across Six US Health Care Systems. Annals Of Emergency Medicine 2021, 79: 158-167. PMID: 34119326, PMCID: PMC8449788, DOI: 10.1016/j.annemergmed.2021.03.013.Peer-Reviewed Original ResearchConceptsHealth care systemCause ED visitsNonfatal opioid overdoseED visitsOpioid use disorderCare systemOpioid overdoseUse disordersCOVID-19 pandemicOpioid-related complicationsEmergency department visitsHospital-based interventionsED visit ratesEmergency department utilizationVisit countsUS health care systemOpioid overdose ratesDepartment visitsHistorical controlsAdult visitsOpioid overdosesOverdose ratesMedical emergencyVisit ratesMore weeks“I wanted to participate in my own care”: Evaluation of a Patient Navigation Program
Samuels EA, Kelley L, Pham T, Cross J, Carmona J, Ellis P, Cobbs-Lomax D, D’Onofrio G, Capp R. “I wanted to participate in my own care”: Evaluation of a Patient Navigation Program. Western Journal Of Emergency Medicine 2021, 22: 417-426. PMID: 33856334, PMCID: PMC7972383, DOI: 10.5811/westjem.2020.9.48105.Peer-Reviewed Original ResearchConceptsFrequent ED usersPatient navigation programsPatient experienceED usersMedical careHealth-related social needsNavigation programPatient navigation interventionPrimary care utilizationHigh satisfactionPost-intervention surveysMixed-methods evaluationNavigation interventionCare utilizationEmergency departmentOutpatient careComprehensive careUS MedicaidOwn careClinic accessibilityIntervention surveyThematic saturationHealth conditionsCareMedicaid
2020
Naloxone Use by Emergency Medical Services During the COVID-19 Pandemic: A National Survey
Cone DC, Bogucki S, Burns K, D’Onofrio G, Hawk K, Joseph D, Fiellin DA. Naloxone Use by Emergency Medical Services During the COVID-19 Pandemic: A National Survey. Journal Of Addiction Medicine 2020, 14: e369-e371. PMID: 33031212, PMCID: PMC7647432, DOI: 10.1097/adm.0000000000000746.Peer-Reviewed Original ResearchConceptsIntranasal naloxoneOverdose eventsEmergency medical services (EMS) cliniciansNovel coronavirus infectionOpioid overdose mortalityEmergency medical servicesOpioid overdose crisisAdministration practicesPercent of respondentsEMS cliniciansEMS fellowship programsIntramuscular naloxoneOpioid overdosesService cliniciansNaloxone useOverdose mortalityNaloxoneFuture disaster planningCoronavirus infectionOverdose crisisCOVID-19 epidemicMedical servicesCOVID-19 pandemicNational surveyCliniciansTrends in the Use of Buprenorphine in US Emergency Departments, 2002-2017
Rhee TG, D’Onofrio G, Fiellin DA. Trends in the Use of Buprenorphine in US Emergency Departments, 2002-2017. JAMA Network Open 2020, 3: e2021209. PMID: 33079195, PMCID: PMC7576404, DOI: 10.1001/jamanetworkopen.2020.21209.Peer-Reviewed Original ResearchTrends in Emergency Department Visits and Hospital Admissions in Health Care Systems in 5 States in the First Months of the COVID-19 Pandemic in the US
Jeffery MM, D’Onofrio G, Paek H, Platts-Mills TF, Soares WE, Hoppe JA, Genes N, Nath B, Melnick ER. Trends in Emergency Department Visits and Hospital Admissions in Health Care Systems in 5 States in the First Months of the COVID-19 Pandemic in the US. JAMA Internal Medicine 2020, 180: 1328-1333. PMID: 32744612, PMCID: PMC7400214, DOI: 10.1001/jamainternmed.2020.3288.Peer-Reviewed Original ResearchConceptsHospital admission ratesEmergency department visitsED visitsHealth care systemAdmission ratesDepartment visitsHospital admissionCare systemCOVID-19 pandemicLarge health care systemAcute care deliveryCross-sectional studyAnnual ED volumeCoronavirus disease 2019Daily ED visitsInflux of patientsPublic health officialsCOVID-19 case ratesCOVID-19 casesNational public healthDisease 2019MAIN OUTCOMEED volumeSerious symptomsContagious infectionWhere Skilled Nursing Facility Residents Get Acute Care: Is the Emergency Department the Medical Home?
Venkatesh AK, Gettel CJ, Mei H, Chou SC, Rothenberg C, Liu SL, D’Onofrio G, Lin Z, Krumholz HM. Where Skilled Nursing Facility Residents Get Acute Care: Is the Emergency Department the Medical Home? Journal Of Applied Gerontology 2020, 40: 828-836. PMID: 32842827, PMCID: PMC7904961, DOI: 10.1177/0733464820950125.Peer-Reviewed Original ResearchConceptsAcute care visitsCare visitsEmergency departmentMedicare beneficiariesSNF staySNF servicesSkilled nursing facility residentsNursing facility residentsSkilled nursing facility servicesAcute care capabilitiesCross-sectional analysisNursing facility servicesHigher proportionAcute careMedical homeFacility residentsCare capabilitiesVisitsNumber of daysStayCareDepartmentFacility servicesBeneficiariesProportionCross‐sectional Analysis of Emergency Department and Acute Care Utilization Among Medicare Beneficiaries
Venkatesh AK, Mei H, Shuling L, D’Onofrio G, Rothenberg C, Lin Z, Krumholz HM. Cross‐sectional Analysis of Emergency Department and Acute Care Utilization Among Medicare Beneficiaries. Academic Emergency Medicine 2020, 27: 570-579. PMID: 32302034, DOI: 10.1111/acem.13971.Peer-Reviewed Original ResearchConceptsMultiple chronic conditionsEmergency departmentUnscheduled careMedicare beneficiariesCross-sectional analysisVisit ratesCare servicesHighest ED visit ratesNumber of EDVulnerable subpopulationsSkilled nursing facility useAmbulatory office settingNon-ED settingsUnscheduled care servicesAcute care utilizationED visit ratesOffice-based visitsAcute care servicesClaims-based definitionNursing facility useMedicare beneficiaries age 65Dual-eligible beneficiariesOlder adult populationBeneficiaries age 65Care visitsBarriers and Facilitators to Clinician Readiness to Provide Emergency Department–Initiated Buprenorphine
Hawk KF, D’Onofrio G, Chawarski MC, O’Connor P, Cowan E, Lyons MS, Richardson L, Rothman RE, Whiteside LK, Owens PH, Martel SH, Coupet E, Pantalon M, Curry L, Fiellin DA, Edelman EJ. Barriers and Facilitators to Clinician Readiness to Provide Emergency Department–Initiated Buprenorphine. JAMA Network Open 2020, 3: e204561. PMID: 32391893, PMCID: PMC7215257, DOI: 10.1001/jamanetworkopen.2020.4561.Peer-Reviewed Original ResearchConceptsOpioid use disorderEmergency departmentAdvanced practice cliniciansED cliniciansClinicians' readinessOngoing treatmentTreatment of OUDEmergency Department-Initiated BuprenorphineUntreated opioid use disorderDrug Addiction Treatment ActDecrease opioid useVisual analog scaleHealth Services frameworkAcademic emergency departmentMixed-methods formative evaluationQuality of careSubset of participantsBuprenorphine initiationClinician typeOpioid useED patientsAnalog scaleOngoing careDepartmental protocolPractice clinicians
2019
User-centred clinical decision support to implement emergency department-initiated buprenorphine for opioid use disorder: protocol for the pragmatic group randomised EMBED trial
Melnick ER, Jeffery MM, Dziura JD, Mao JA, Hess EP, Platts-Mills TF, Solad Y, Paek H, Martel S, Patel MD, Bankowski L, Lu C, Brandt C, D’Onofrio G. User-centred clinical decision support to implement emergency department-initiated buprenorphine for opioid use disorder: protocol for the pragmatic group randomised EMBED trial. BMJ Open 2019, 9: e028488. PMID: 31152039, PMCID: PMC6550013, DOI: 10.1136/bmjopen-2018-028488.Peer-Reviewed Original ResearchMeSH KeywordsAdultBuprenorphineCluster AnalysisDecision Support Systems, ClinicalEmergency Service, HospitalFemaleHumansMaleMiddle AgedMulticenter Studies as TopicNarcotic AntagonistsOpiate Substitution TreatmentOpioid-Related DisordersPragmatic Clinical Trials as TopicRandomized Controlled Trials as TopicUnited StatesYoung AdultConceptsOpioid use disorderEmergency departmentSecondary outcomesUse disordersEmergency department-initiated buprenorphineWestern Institutional Review BoardData Safety Monitoring BoardIndependent study monitorsRates of cliniciansRoutine emergency careSafety monitoring boardInstitutional review boardClinical decision support systemClinician prescribingPragmatic clusterPatient characteristicsPeer-reviewed journalsClinical decision supportPrimary outcomeED cliniciansWithdrawal symptomsOngoing treatmentPatients' willingnessMonitoring boardBuprenorphineImplementation facilitation to promote emergency department-initiated buprenorphine for opioid use disorder: protocol for a hybrid type III effectiveness-implementation study (Project ED HEALTH)
D’Onofrio G, Edelman EJ, Hawk KF, Pantalon MV, Chawarski MC, Owens PH, Martel SH, VanVeldhuisen P, Oden N, Murphy SM, Huntley K, O’Connor P, Fiellin DA. Implementation facilitation to promote emergency department-initiated buprenorphine for opioid use disorder: protocol for a hybrid type III effectiveness-implementation study (Project ED HEALTH). Implementation Science 2019, 14: 48. PMID: 31064390, PMCID: PMC6505286, DOI: 10.1186/s13012-019-0891-5.Peer-Reviewed Original ResearchConceptsOpioid use disorderEmergency departmentImplementation facilitationCost-effectiveness analysisUse disordersPatient engagementEmergency department-initiated buprenorphineEffectiveness-implementation studyEvaluation periodOpioid agonist treatmentSoft tissue infectionsInjection drug useGeneral medical conditionsHealth Services frameworkClinical Trials NetworkAcademic emergency departmentRate of provisionIF interventionOngoing medicationED visitsTissue infectionsED patientsFacilitated referralAgonist treatmentED providers