Factors related to substance use treatment attendance after peer recovery coach intervention in the emergency department

Ware, Orrin D.; Buresh, Megan; Irvin, Nathan; Stitzer, Maxine L.; Sweeney, Mary M.

doi:10.1016/j.dadr.2022.100093

Cited by 5 publications

(4 citation statements)

References 60 publications

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“… 45 , 46 As reported by peers in qualitative studies, challenges interfering with service delivery include role confusion, 47 health care practitioner stigma, 45 low awareness of peers’ roles, 48 inadequate training and supervision, 47 , 48 and burnout due to the work’s irregular schedule and emotionally taxing nature. 43 , 46 Unmeasured patient-level factors (eg, readiness for change) 49 and community-level factors (eg, treatment access and psychosocial resources) may further account for differences. Given the variation in implementation models for ED-based PRSSs, there is a need for further research aided by development of a fidelity measure to identify key intervention components of ED-based PRSSs and the factors influencing effectiveness.…”

Section: Discussionmentioning

confidence: 99%

Emergency Department Peer Support Program and Patient Outcomes After Opioid Overdose

Treitler,

Crystal,

Cantor

et al. 2024

JAMA Netw Open

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ImportancePatients treated in emergency departments (EDs) for opioid overdose often need drug treatment yet are rarely linked to services after discharge. Emergency department–based peer support is a promising approach for promoting treatment linkage, but evidence of its effectiveness is lacking.ObjectiveTo examine the association of the Opioid Overdose Recovery Program (OORP), an ED peer recovery support service, with postdischarge addiction treatment initiation, repeat overdose, and acute care utilization.Design, Setting, and ParticipantsThis intention-to-treat retrospective cohort study used 2014 to 2020 New Jersey Medicaid data for Medicaid enrollees aged 18 to 64 years who were treated for nonfatal opioid overdose from January 2015 to June 2020 at 70 New Jersey acute care hospitals. Data were analyzed from August 2022 to November 2023.ExposureHospital OORP implementation.Main Outcomes and MeasuresThe primary outcome was medication for opioid use disorder (MOUD) initiation within 60 days of discharge. Secondary outcomes included psychosocial treatment initiation, medically treated drug overdoses, and all-cause acute care visits after discharge. An event study design was used to compare 180-day outcomes between patients treated in OORP hospitals and those treated in non-OORP hospitals. Analyses adjusted for patient demographics, comorbidities, and prior service use and for community-level sociodemographics and drug treatment access.ResultsA total of 12 046 individuals were included in the study (62.0% male). Preimplementation outcome trends were similar for patients treated in OORP and non-OORP hospitals. Implementation of the OORP was associated with an increase of 0.034 (95% CI, 0.004-0.064) in the probability of 60-day MOUD initiation in the half-year after implementation, representing a 45% increase above the preimplementation mean probability of 0.075 (95% CI, 0.066-0.084). Program implementation was associated with fewer repeat medically treated overdoses 4 half-years (−0.086; 95% CI, −0.154 to −0.018) and 5 half-years (−0.106; 95% CI, −0.184 to −0.028) after implementation. Results differed slightly depending on the reference period used, and hospital-specific models showed substantial heterogeneity in program outcomes across facilities.Conclusions and RelevanceIn this cohort study of patients treated for opioid overdose, OORP implementation was associated with an increase in MOUD initiation and a decrease in repeat medically treated overdoses. The large variation in outcomes across hospitals suggests that treatment effects were heterogeneous and may depend on factors such as implementation success, program embeddedness, and availability of other hospital- and community-based OUD services.

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Section: Discussionmentioning

confidence: 99%

Emergency Department Peer Support Program and Patient Outcomes After Opioid Overdose

Treitler,

Crystal,

Cantor

et al. 2024

JAMA Netw Open

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“…A quantitative analysis on factors associated with linkage to treatment following ED referral was conducted in a separate study. 32 The present study focused on items regarding substance abstinence. Specifically, during the brief intervention, the peer recovery specialist is prompted by a standardized form with the question, “Has the patient ever had sustained abstinence?” The peer recovery specialist responds to this question with a dichotomous option of “Yes” or “No.” An affirmative response is followed by an open-ended text-box that the peer recovery specialist asks about and then records a description of the prior period of sustained abstinence.…”

Section: Methodsmentioning

confidence: 99%

“…This period of sustained abstinence was open to the patient’s own personal interpretation. The sample for the present study includes all patients during the query period that met the following criteria: (1) were included in the quantitative dataset, 32 (2) had an AUD diagnosis documented in the electronic health record, (3) were documented as either attended or did not attend treatment following the referral, (4) indicated “Yes” for having a prior period of abstinence, and (5) had an open-ended response which described their period of abstinence. A consort diagram of this study may be found in the Supplemental Material .…”

Section: Methodsmentioning

confidence: 99%

Section: Samplementioning

confidence: 99%

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Prior Periods of Abstinence Among Adults With an Alcohol Use Disorder: A Qualitative Template Analysis

et al. 2023

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Abstaining from substance use is a goal of many people with alcohol use disorder (AUD). Understanding patient perspectives of a period of abstinence may assist persons with AUD in achieving this goal. We accessed the electronic health records of adults with AUD entering an emergency department in Baltimore, Maryland, who received a brief peer support intervention for substance use. Data contained open-ended text entered by staff after a patient indicated ever having a sustained period of substance abstinence. Using qualitative template analysis methodology, we identified codes and themes from these open-ended responses from N = 153 adults with AUD. The sample was primarily male (n = 109, 71.2%) and White (n = 98, 64.1%) with an average age of 43.8 years (SD = 11.2). Themes identified included the abstinence length, abstinence reason, relapse, triggers, time of relapse, and treatment. The most common code for abstinence length was “between 1 and 5 years” (n = 55, 35.9%). Other abstinence length codes included “less than 1 year” and “more than 5 years.” Relapse triggers included “family (non-death),” “death of a loved one,” “social,” “economic,” and “treatment-related” reasons. Findings from this study could be used to inform strategies for peer support interventions to assist patients with substance abstinence.

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Latent class analysis of emergency department patients engaged in telehealth peer recovery support services and associations of identified classes with post-discharge outcomes

Watson,

Swartz,

Magee

et al. 2024

Journal of Substance Use and Addiction Treatment

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Factors related to substance use treatment attendance after peer recovery coach intervention in the emergency department

Cited by 5 publications

References 60 publications

Emergency Department Peer Support Program and Patient Outcomes After Opioid Overdose

Emergency Department Peer Support Program and Patient Outcomes After Opioid Overdose

Prior Periods of Abstinence Among Adults With an Alcohol Use Disorder: A Qualitative Template Analysis

Latent class analysis of emergency department patients engaged in telehealth peer recovery support services and associations of identified classes with post-discharge outcomes

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