Models for Implementing Emergency Department–Initiated Buprenorphine With Referral for Ongoing Medication Treatment at Emergency Department Discharge in Diverse Academic Centers - 18/10/22
, Gail D’Onofrio, MD b, c, David A. Fiellin, MD b, c, d, E. Jennifer Edelman, MD, MHS c, d, Lynne Richardson, MD e, Patrick O’Connor, MD, MPH c, Richard E. Rothman, MD, PhD f, Ethan Cowan, MD, MS e, Michael S. Lyons, MD, MPH g, h, Callan E. Fockele, MD, MS a, Mustapha Saheed, MD f, Caroline Freiermuth, MD g, h, Brittany E. Punches, PhD, RN g, h, Clara Guo b, Shara Martel b, Patricia H. Owens b, Edouard Coupet b, Kathryn F. Hawk, MD, MHS b, cAbstract |
There has been a substantial rise in the number of publications and training opportunities on the care and treatment of emergency department (ED) patients with opioid use disorder over the past several years. The American College of Emergency Physicians recently published recommendations for providing buprenorphine to patients with opioid use disorder, but barriers to implementing this clinical practice remain. We describe the models for implementing ED-initiated buprenorphine at 4 diverse urban, academic medical centers across the country as part of a federally funded effort termed “Project ED Health.” These 4 sites successfully implemented unique ED-initiated buprenorphine programs as part of a comparison of implementation facilitation to traditional educational dissemination on the uptake of ED-initiated buprenorphine. Each site describes the elements central to the ED process, including screening, treatment initiation, referral, and follow-up, while harnessing organizational characteristics, including ED culture. Finally, we discuss common facilitators to program success, including information technology and electronic medical record integration, hospital-level support, strong connections with outpatient partners, and quality improvement processes.
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| Supervising editor: Donald M. Yealy, MD |
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| All authors attest to meeting the four ICMJE.org authorship criteria: (1) Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND (2) Drafting the work or revising it critically for important intellectual content; AND (3) Final approval of the version to be published; AND (4) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. |
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| Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org/). The authors have stated that no such relationships exist. Funded by National Institute on Drug Abuse (NIDA) grant 5UG1DA015831-15 CTN-0069 and K23DA039974. |
Vol 80 - N° 5
P. 410-419 - novembre 2022 Retour au numéro
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