2023
Perspectives on and experiences of emergency department–initiated buprenorphine among clinical pharmacists: A multi-site qualitative study
Justen M, Edelman E, Chawarski M, Coupet E, Cowan E, Lyons M, Owens P, Martel S, Richardson L, Rothman R, Whiteside L, O'Connor P, Zahn E, D'Onofrio G, Fiellin D, Hawk K. Perspectives on and experiences of emergency department–initiated buprenorphine among clinical pharmacists: A multi-site qualitative study. Journal Of Substance Use And Addiction Treatment 2023, 155: 209058. PMID: 37149149, DOI: 10.1016/j.josat.2023.209058.Peer-Reviewed Original ResearchConceptsOpioid use disorderClinical pharmacistsED careEmergency department-initiated buprenorphineEffective OUD treatmentEffectiveness-implementation studyHealth Services frameworkFocus groups/interviewsMulti-site qualitative studyFuture implementation effortsOUD treatmentUrban EDGroups/interviewsEmergency departmentPromoting ActionUnique pharmacologyED staffBuprenorphinePharmacist participantsUse disordersED contextPharmacistsPractice changePharmacy resourcesSuccessful program implementationPerspectives of Clinicians and Staff at Community-Based Opioid Use Disorder Treatment Settings on Linkages With Emergency Department–Initiated Buprenorphine Programs
Sue K, Chawarski M, Curry L, McNeil R, Coupet E, Schwartz R, Wilder C, Tsui J, Hawk K, D’Onofrio G, O’Connor P, Fiellin D, Edelman E. Perspectives of Clinicians and Staff at Community-Based Opioid Use Disorder Treatment Settings on Linkages With Emergency Department–Initiated Buprenorphine Programs. JAMA Network Open 2023, 6: e2312718. PMID: 37163263, PMCID: PMC10173026, DOI: 10.1001/jamanetworkopen.2023.12718.Peer-Reviewed Original ResearchConceptsCommunity-based cliniciansOpioid use disorderEmergency departmentOUD treatmentMedication treatmentSubstance use disorders trainingUrban academic emergency departmentEffectiveness-implementation studyAcademic emergency departmentDisorder treatment settingsPerspectives of cliniciansCommunity-based treatmentCommunity-based treatment programsStaff perspectivesImplementation science frameworkBuprenorphine programTreatment cliniciansPeer navigatorsReferral sitesPromoting ActionMAIN OUTCOMEED staffBuprenorphineFocus groupsUse disordersImplementation Facilitation to Promote Emergency Department–Initiated Buprenorphine for Opioid Use Disorder
D’Onofrio G, Edelman E, Hawk K, Chawarski M, Pantalon M, Owens P, Martel S, Rothman R, Saheed M, Schwartz R, Cowan E, Richardson L, Salsitz E, Lyons M, Freiermuth C, Wilder C, Whiteside L, Tsui J, Klein J, Coupet E, O’Connor P, Matthews A, Murphy S, Huntley K, Fiellin D. Implementation Facilitation to Promote Emergency Department–Initiated Buprenorphine for Opioid Use Disorder. JAMA Network Open 2023, 6: e235439. PMID: 37017967, PMCID: PMC10077107, DOI: 10.1001/jamanetworkopen.2023.5439.Peer-Reviewed Original ResearchConceptsOpioid use disorderRate of patientsOUD treatmentImplementation facilitationED visitsObservational cohortED cliniciansX-waiverUse disordersEmergency Department-Initiated BuprenorphineUntreated opioid use disorderEvaluation periodHybrid type 3Provision of buprenorphineBaseline periodGrand roundsRates of EDPrimary outcomeWhite patientsAcademic EDBlack patientsED patientsEmergency departmentCommunity cliniciansMAIN OUTCOME
2022
Missed Opportunities for HIV and Hepatitis C Screening Among Emergency Department Patients With Untreated Opioid Use Disorder
Lyons MS, Chawarski MC, Rothman R, Whiteside L, Cowan E, Richardson LD, Hawk K, Tsui JI, Schwartz RP, O’Connor P, D’Onofrio G, Fiellin DA, Edelman EJ. Missed Opportunities for HIV and Hepatitis C Screening Among Emergency Department Patients With Untreated Opioid Use Disorder. Journal Of Addiction Medicine 2022, 17: 210-214. PMID: 36170184, PMCID: PMC10023471, DOI: 10.1097/adm.0000000000001074.Peer-Reviewed Original ResearchConceptsUntreated opioid use disorderOpioid use disorderRecent injection drug useEmergency department HIVInjection drug useHCV screeningED patientsUse disordersEnrollment periodDrug useHepatitis C screeningStructured screening programmeUnknown HCV statusUnknown HIV statusHigh-risk cohortMedical care providersHCV statusC screeningHepatitis CED visitsAcademic EDHIV statusEmergency departmentCohort 2Cohort 1Models for Implementing Emergency Department–Initiated Buprenorphine With Referral for Ongoing Medication Treatment at Emergency Department Discharge in Diverse Academic Centers
Whiteside LK, D'Onofrio G, Fiellin DA, Edelman EJ, Richardson L, O'Connor P, Rothman RE, Cowan E, Lyons MS, Fockele CE, Saheed M, Freiermuth C, Punches BE, Guo C, Martel S, Owens PH, Coupet E, Hawk KF. Models for Implementing Emergency Department–Initiated Buprenorphine With Referral for Ongoing Medication Treatment at Emergency Department Discharge in Diverse Academic Centers. Annals Of Emergency Medicine 2022, 80: 410-419. PMID: 35752520, PMCID: PMC9588652, DOI: 10.1016/j.annemergmed.2022.05.010.Peer-Reviewed Original ResearchConceptsOpioid use disorderUse disordersEmergency Department-Initiated BuprenorphineEmergency department dischargeEmergency department patientsElectronic medical record integrationAcademic medical centerBuprenorphine programDepartment patientsTreatment initiationMedication treatmentEmergency physiciansMedical CenterAmerican CollegeClinical practiceImplementation facilitationQuality improvement processBuprenorphineCommon facilitatorsRecord integrationPatientsReferralED cultureEducational disseminationDisordersCharacterizing the social support and functioning of a low-threshold medication for opioid use disorder treatment cohort at intake
Oles W, Alexander M, Kumar N, Howell B, O’Connor P, Madden LM, Barry DT. Characterizing the social support and functioning of a low-threshold medication for opioid use disorder treatment cohort at intake. BMC Psychiatry 2022, 22: 236. PMID: 35366844, PMCID: PMC8976510, DOI: 10.1186/s12888-022-03884-5.Peer-Reviewed Original ResearchConceptsLow-threshold clinicDemographic characteristicsOpioid use disorder treatmentMultivariate logistic regression modelBrief Pain InventoryPatient demographic characteristicsOpioid use disorderSocial supportSymptom Identification ScaleUse disorder treatmentNon-Hispanic whitesLogistic regression modelsOlder patientsPain InventoryTreatment cohortsSelf-reported social supportLife Events ChecklistMOUD treatmentBaseline disparitiesTreatment accessTreatment needsHigh riskUse disordersMortality rateDisorder treatmentPerspectives 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 careThe Impact of Access to Addiction Specialist on Attitudes, Beliefs and Hospital-Based Opioid Use Disorder Related Care: A Survey of Hospitalist Physicians
Calcaterra SL, Binswanger IA, Edelman EJ, McNair BK, Wakeman SE, O'Connor P. The Impact of Access to Addiction Specialist on Attitudes, Beliefs and Hospital-Based Opioid Use Disorder Related Care: A Survey of Hospitalist Physicians. Substance Use & Addiction Journal 2022, 43: 143-151. PMID: 32267807, PMCID: PMC7541600, DOI: 10.1080/08897077.2020.1748169.Peer-Reviewed Original ResearchConceptsOpioid use disorderAddiction specialistsLocal treatment resourcesLife-saving treatmentBuprenorphine initiationMultivariable analysisOUD careScreening practicesHospitalist physiciansUse disordersClinical practicePatientsRelated careTreatment resourcesHospitalistsHarm reductionCareTreatmentUnited StatesSpecialistsOnline surveyHospitalizationBuprenorphineComplicationsPrescribing
2021
The design and conduct of a randomized clinical trial comparing emergency department initiation of sublingual versus a 7-day extended-release injection formulation of buprenorphine for opioid use disorder: Project ED Innovation
D'Onofrio G, Hawk KF, Herring AA, Perrone J, Cowan E, McCormack RP, Dziura J, Taylor RA, Coupet E, Edelman EJ, Pantalon MV, Owens PH, Martel SH, O'Connor PG, Van Veldhuisen P, DeVogel N, Huntley K, Murphy SM, Lofwall MR, Walsh SL, Fiellin DA. The design and conduct of a randomized clinical trial comparing emergency department initiation of sublingual versus a 7-day extended-release injection formulation of buprenorphine for opioid use disorder: Project ED Innovation. Contemporary Clinical Trials 2021, 104: 106359. PMID: 33737199, PMCID: PMC9153252, DOI: 10.1016/j.cct.2021.106359.Peer-Reviewed Original ResearchConceptsOpioid use disorderRandomized clinical trialsPrimary outcomeFormal addiction treatmentOpioid withdrawalClinical trialsAncillary studiesUse disordersSelf-reported opioid useAddiction treatmentEmergency department initiationIncremental cost-effectiveness ratioReceipt of medicationEmergency department studyHealth service utilizationCost-effectiveness ratioOpioid useSecondary outcomesService utilizationTreatment accessEligibility criteriaImplementation facilitationBuprenorphineOverdose eventsDepartment studyThe role of social network support in treatment outcomes for medication for opioid use disorder: A systematic review
Kumar N, Oles W, Howell BA, Janmohamed K, Lee ST, Funaro MC, O'Connor PG, Alexander M. The role of social network support in treatment outcomes for medication for opioid use disorder: A systematic review. Journal Of Substance Use And Addiction Treatment 2021, 127: 108367. PMID: 34134871, PMCID: PMC9022048, DOI: 10.1016/j.jsat.2021.108367.Peer-Reviewed Original ResearchConceptsOpioid use disorderUse disordersTreatment outcomesMedication treatmentMOUD treatmentSystematic reviewOpioid use disorder treatmentSocial network supportPositive social support networksUse disorder treatmentPatients' oddsOpioid deathsPatient populationSuccessful treatmentOpioid epidemicInclusion criteriaResearch DatabaseElectronic research databasesHealthy behaviorsDisorder treatmentTools physiciansTargeted interventionsDisordersMedicationsTreatment
2020
Emergency department patients with untreated opioid use disorder: A comparison of those seeking versus not seeking referral to substance use treatment
Coupet E, D’Onofrio G, Chawarski M, Edelman E, O’Connor P, Owens P, Martel S, Fiellin DA, Cowan E, Richardson L, Huntley K, Whiteside LK, Lyons MS, Rothman RE, Pantalon M, Hawk K. Emergency department patients with untreated opioid use disorder: A comparison of those seeking versus not seeking referral to substance use treatment. Drug And Alcohol Dependence 2020, 219: 108428. PMID: 33307301, PMCID: PMC8110210, DOI: 10.1016/j.drugalcdep.2020.108428.Peer-Reviewed Original ResearchConceptsUntreated opioid use disorderOpioid use disorderEmergency department patientsDepartment patientsUse disordersTenth Revision diagnosis codesSevere opioid use disorderConclusions Most patientsInjection-related infectionsRevision diagnosis codesHealth insurance statusSubstance use treatmentCross-sectional analysisOpioid withdrawalClinical characteristicsED visitsMost patientsTreatment initiationUrine toxicologyClinical correlatesDiagnosis codesInsurance statusUnivariate analysisBackground LittleInternational ClassificationValidating Self‐Reported Unhealthy Alcohol Use With Phosphatidylethanol (PEth) Among Patients With HIV
Eyawo O, Deng Y, Dziura J, Justice AC, McGinnis K, Tate JP, Rodriguez‐Barradas M, Hansen NB, Maisto SA, Marconi VC, O’Connor P, Bryant K, Fiellin DA, Edelman EJ. Validating Self‐Reported Unhealthy Alcohol Use With Phosphatidylethanol (PEth) Among Patients With HIV. Alcohol Clinical And Experimental Research 2020, 44: 2053-2063. PMID: 33460225, PMCID: PMC8856627, DOI: 10.1111/acer.14435.Peer-Reviewed Original ResearchConceptsUnhealthy alcohol useSignificant alcohol useHeavy drinking daysAlcohol use disorderTimeline FollowbackAlcohol useSelf-reported alcohol useNumber of drinksClinical trialsRisk drinkingUse disordersDrinking daysBiomarker-based evidenceSample of PWHDrinks/dayMean numberSelf-reported alcohol consumptionMagnitude of associationBlood spot samplesLiver diseasePEth levelsTLFB interviewAlcohol consumptionLogistic regressionPatientsAddiction Psychiatry and Addiction Medicine: The Evolution of Addiction Physician Specialists
Nunes EV, Kunz K, Galanter M, O'Connor PG. Addiction Psychiatry and Addiction Medicine: The Evolution of Addiction Physician Specialists. American Journal On Addictions 2020, 29: 390-400. PMID: 32902056, DOI: 10.1111/ajad.13068.Peer-Reviewed Original ResearchConceptsSubstance use disordersAddiction medicineUse disordersAddiction psychiatryAddiction medicine fellowshipsAmerican BoardPublic health challengeWorkforce of physiciansMedical comorbiditiesGeneral medicalSpecialty settingsPhysician specialistsClinical settingPractice pathwayHealth challengesPrimary specialtyFellowship trainingPreventive medicineActive diplomatesMedical specialtiesTraining program requirementsAccreditation CouncilDisordersMedicineDiplomatesUse of Amphetamine-Type Stimulants Among Emergency Department Patients With Untreated Opioid Use Disorder
Chawarski MC, Hawk K, Edelman EJ, O'Connor P, Owens P, Martel S, Coupet E, Whiteside L, Tsui JI, Rothman R, Cowan E, Richardson L, Lyons MS, Fiellin DA, D'Onofrio G. Use of Amphetamine-Type Stimulants Among Emergency Department Patients With Untreated Opioid Use Disorder. Annals Of Emergency Medicine 2020, 76: 782-787. PMID: 32782084, PMCID: PMC8048036, DOI: 10.1016/j.annemergmed.2020.06.046.Peer-Reviewed Original ResearchConceptsUntreated opioid use disorderOpioid use disorderAmphetamine-type stimulant useUse disordersStimulant useAmphetamine-type stimulantsStudy admissionEmergency departmentEmergency department patientsImplementation science studyUrine test resultsFalse discovery rate correctionSubstance use problemsHepatitis CED visitsDepartment patientsReferral protocolsED patientsUrine testsDrug injectionOverdose riskPatientsHealth factorsUnstable housingConcurrent useInpatient adoption of medications for alcohol use disorder: A mixed-methods formative evaluation involving key stakeholders
Joudrey PJ, Oldfield BJ, Yonkers KA, O'Connor PG, Berland G, Edelman EJ. Inpatient adoption of medications for alcohol use disorder: A mixed-methods formative evaluation involving key stakeholders. Drug And Alcohol Dependence 2020, 213: 108090. PMID: 32559667, PMCID: PMC7375447, DOI: 10.1016/j.drugalcdep.2020.108090.Peer-Reviewed Original ResearchIntervention characteristicsUrban academic medical centerLarge urban academic medical centerHealth professionals' knowledgeCharacteristics of individualsMixed-methods formative evaluationAcademic medical centerAlcohol use disorderStigma of peopleClinical evidencePatient preferencesInpatient settingMedical CenterTreatment goalsImplementation interventionsPrescribing professionalsPatient vulnerabilitySide effectsUse disordersOuter settingHealth professionalsInner settingConsolidated FrameworkCFIR constructsOrganizational prioritizationComputerized Cognitive Behavioral Therapy for Substance Use Disorders in a Specialized Primary Care Practice: A Randomized Feasibility Trial to Address the RT Component of SBIRT.
Tetrault JM, Holt SR, Cavallo DA, O'Connor PG, Gordon MA, Corvino JK, Nich C, Carroll KM. Computerized Cognitive Behavioral Therapy for Substance Use Disorders in a Specialized Primary Care Practice: A Randomized Feasibility Trial to Address the RT Component of SBIRT. Journal Of Addiction Medicine 2020, 14: e303-e309. PMID: 32371660, DOI: 10.1097/adm.0000000000000663.Peer-Reviewed Original ResearchConceptsSubstance use disordersComputerized cognitive behavioral therapySubstance useCognitive behavioral therapySelf-reported substance useUse disordersTechnology-based treatmentsPrimary care settingSubstance use outcomesIntegrated addictions treatmentTechnology-based interventionsBehavioral therapyPrimary care practicesOverall positive outcomeSUD interventionsBrief interventionUnhealthy alcohol useDays abstinentPositive outcomesUse outcomesCare settingsAlcohol useStandard careAddiction treatmentTreatment settings
2019
Integrated stepped alcohol treatment for patients with HIV and alcohol use disorder: a randomised controlled trial
Edelman EJ, Maisto SA, Hansen NB, Cutter CJ, Dziura J, Deng Y, Fiellin LE, O'Connor PG, Bedimo R, Gibert CL, Marconi VC, Rimland D, Rodriguez-Barradas MC, Simberkoff MS, Tate JP, Justice AC, Bryant KJ, Fiellin DA. Integrated stepped alcohol treatment for patients with HIV and alcohol use disorder: a randomised controlled trial. The Lancet HIV 2019, 6: e509-e517. PMID: 31109915, PMCID: PMC7161741, DOI: 10.1016/s2352-3018(19)30076-1.Peer-Reviewed Original ResearchConceptsAlcohol use disorderWeek 24Use disordersAlcohol treatmentAdverse eventsNumber of drinksTreatment medicationsPhysician managementAlcohol abuseMental Disorders-IV criteriaAlcohol-related careFormal alcohol treatmentKey exclusion criteriaTimeline followback methodMotivational enhancement therapyTreat populationHIV clinicHIV outcomesPrimary outcomeSpecialty referralsMean ageUS National InstitutesWeek 4Medical conditionsExclusion criteriaImplementation 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 providersA randomized trial of decision support for tobacco dependence treatment in an inpatient electronic medical record: clinical results
Bernstein SL, Weiss J, DeWitt M, Tetrault JM, Hsiao AL, Dziura J, Sussman S, Miller T, Carpenter K, O’Connor P, Toll B. A randomized trial of decision support for tobacco dependence treatment in an inpatient electronic medical record: clinical results. Implementation Science 2019, 14: 8. PMID: 30670043, PMCID: PMC6343239, DOI: 10.1186/s13012-019-0856-8.Peer-Reviewed Original ResearchConceptsPatient's primary care providerPrimary care providersTobacco treatment medicationsElectronic health recordsTobacco use disorderQuit ratesTreatment medicationsProblem listCare providersUse disordersOne-year quit ratesState tobacco quitlineTobacco quit ratesPrescription of medicationsTobacco dependence treatmentProcess of careSingle hospital systemElectronic medical recordsInpatient electronic medical recordPatient's problem listSustained quittingAdult patientsControl patientsCurrent smokingHospitalized smokers
2017
Past‐year Prescription Drug Monitoring Program Opioid Prescriptions and Self‐reported Opioid Use in an Emergency Department Population With Opioid Use Disorder
Hawk K, D'Onofrio G, Fiellin DA, Chawarski MC, O'Connor PG, Owens PH, Pantalon MV, Bernstein SL. Past‐year Prescription Drug Monitoring Program Opioid Prescriptions and Self‐reported Opioid Use in an Emergency Department Population With Opioid Use Disorder. Academic Emergency Medicine 2017, 25: 508-516. PMID: 29165853, PMCID: PMC5963969, DOI: 10.1111/acem.13352.Peer-Reviewed Original ResearchConceptsPrescription drug monitoring programsOpioid use disorderNonmedical prescription opioid usePrescription opioid useAberrant drug-related behaviorsOpioid useOpioid prescriptionsUse disordersED patientsDrug-related behaviorsPrescription recordsState prescription drug monitoring programStatistical Manual IV criteriaNonmedical opioid useRandomized clinical trialsEmergency department assessmentEmergency department populationDrug monitoring programsCharacteristics of participantsUrban EDOpioid dependencePrescription opioidsPDMP dataTreatment trialsClinical history