Naloxone and Buprenorphine Prescribing Following US Emergency Department Visits for Suspected Opioid Overdose: August 2019 to April 2021

Chua, Kao-Ping; Dahlem, Chin Hwa Y.; Nguyễn, Thủy; Brummett, Chad M.; Conti, Rena M.; Bohnert, Amy S. B.; Dora‐Laskey, Aaron; Kocher, Keith E.

doi:10.1016/j.annemergmed.2021.10.005

Cited by 27 publications

(31 citation statements)

References 28 publications

(42 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 25 , 26 These data have been previously used to examine short-term changes in overall buprenorphine and naloxone prescriptions in the early pandemic months, as well as racial and ethnic disparities in diagnoses and medication dispensing for HIV. 19 , 24 , 27 , 28 Our sample included 1 556 860 and 127 506 unique individuals who filled buprenorphine and XR naltrexone prescriptions, respectively, during May 6, 2019, to June 5, 2021.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Racial and Ethnic Disparities in Buprenorphine and Extended-Release Naltrexone Filled Prescriptions During the COVID-19 Pandemic

et al. 2022

View full text Add to dashboard Cite

show abstract

Section: Methodsmentioning

confidence: 99%

“… 23 However, it remains unclear whether pandemic disruptions of these treatments were also concentrated among racial and ethnic minority groups. Trends beyond the initial acute months of the pandemic are also important, but prior studies 19 , 20 , 24 of MOUD prescribing during COVID-19 focused on limited time frames and samples.…”

Section: Introductionmentioning

confidence: 99%

Racial and Ethnic Disparities in Buprenorphine and Extended-Release Naltrexone Filled Prescriptions During the COVID-19 Pandemic

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Despite this and other evidence supporting ED-initiated buprenorphine, patients with OUD infrequently receive MOUD, including buprenorphine, during an ED encounter. A recent study found that less than 10% of all patients in the US were prescribed buprenorphine within 30 days of their ED visit for an opioid overdose . The baseline rate for patients included in our study was even lower at approximately 5%.…”

Section: Discussionmentioning

confidence: 99%

Association Between Hospital Adoption of an Emergency Department Treatment Pathway for Opioid Use Disorder and Patient Initiation of Buprenorphine After Discharge

et al. 2023

View full text Add to dashboard Cite

ImportanceEmergency department (ED)–based initiation of buprenorphine has been shown to increase engagement in outpatient treatment and reduce the risk of subsequent opioid overdose; however, rates of buprenorphine treatment in the ED and follow-up care for opioid use disorder (OUD) remain low in the US. The Opioid Hospital Quality Improvement Program (O-HQIP), a statewide financial incentive program designed to increase engagement in OUD treatment for Medicaid-enrolled patients who have ED encounters, has the potential to increase ED-initiated buprenorphine treatment.ObjectiveTo evaluate the association between hospitals attesting to an ED buprenorphine treatment O-HQIP pathway and patients’ subsequent initiation of buprenorphine treatment.Design, Setting, and ParticipantsThis cohort study included Pennsylvania patients aged 18 to 64 years with continuous Medicaid enrollment 6 months before their OUD ED encounter and at least 30 days after discharge between January 1, 2016, and December 31, 2020. Patients with a claim for medication for OUD 6 months before their index encounter were excluded.ExposuresHospital implementation of an ED buprenorphine treatment O-HQIP pathway.Main Outcomes and MeasuresThe main outcome was patients’ receipt of buprenorphine within 30 days of their index OUD ED visit. Between August 2021 and January 2023, data were analyzed using a difference-in-differences method to evaluate the association between hospitals’ O-HQIP attestation status and patients’ treatment with buprenorphine after ED discharge.ResultsThe analysis included 17 428 Medicaid-enrolled patients (female, 43.4%; male, 56.6%; mean [SD] age, 37.4 [10.8] years; Black, 17.5%; Hispanic, 7.9%; White, 71.6%; other race or ethnicity, 3.0%) with OUD seen at O-HQIP–attesting or non–O-HQIP–attesting hospital EDs. The rate of prescription fills for buprenorphine within 30 days of an OUD ED discharge in the O-HQIP attestation hospitals before the O-HQIP intervention was 5%. The O-HQIP attestation was associated with a statistically significant increase (2.6 percentage points) in prescription fills for buprenorphine within 30 days of an OUD ED discharge (β, 0.026; 95% CI, 0.005-0.047).Conclusions and RelevanceIn this cohort study, the O-HQIP was associated with an increased initiation of buprenorphine in patients with OUD presenting to the ED. These findings suggest that statewide incentive programs may effectively improve outcomes for patients with OUD.

show abstract

“…3,6,7 Despite thousands of ED visits annually for opioid overdoses and injection-related medical concerns and increasing data supporting the practice, few patients with OUD are started on buprenorphine during or immediately after an ED visit-in one study, less than 5% of over 6000 patients discharged from the ED after a nonfatal overdose filled a prescription for buprenorphine in the subsequent 90 days. [8][9][10][11] To understand why the implementation of ED-based buprenorphine has lagged, research has focused on clinician-reported barriers to administering buprenorphine, including regulatory requirements, lack of training and infrastructure, discomfort and stigma, and perceived lack of appropriate follow-up care. [11][12][13][14][15][16][17][18][19] However, the decision to initiate buprenorphine or methadone also involves patients, who have their own beliefs, preferences, and perspectives.…”

Section: Introductionmentioning

confidence: 99%

“Just give them a choice”: Patients' perspectives on starting medications for opioid use disorder in the ED

Schoenfeld

Westafer

Beck

et al. 2022

Academic Emergency Medicine

View full text Add to dashboard Cite

Objectives: Medications for opioid use disorder (MOUD) prescribed in the emergency department (ED) have the potential to save lives and help people start and maintain recovery. We sought to explore patient perspectives regarding the initiation of buprenorphine and methadone in the ED with the goal of improving interactions and fostering shared decision making (SDM) around these important treatment options. Methods:We conducted semistructured interviews with a purposeful sample of people with opioid use disorder (OUD) regarding ED visits and their experiences with MOUD. The interview guide was based on the Ottawa Decision Support Framework, a framework for examining decisional needs and tailoring decisional support, and the research team's experience with MOUD and SDM. Interviews were recorded, transcribed, and analyzed in an iterative process using both the Ottawa Framework and a social-ecological framework. Themes were identified and organized and implications for clinical care were noted and discussed.Results: Twenty-six participants were interviewed, seven in person in the ED and 19 via video conferencing software. The majority had tried both buprenorphine

show abstract

Naloxone and Buprenorphine Prescribing Following US Emergency Department Visits for Suspected Opioid Overdose: August 2019 to April 2021

Cited by 27 publications

References 28 publications

Racial and Ethnic Disparities in Buprenorphine and Extended-Release Naltrexone Filled Prescriptions During the COVID-19 Pandemic

Racial and Ethnic Disparities in Buprenorphine and Extended-Release Naltrexone Filled Prescriptions During the COVID-19 Pandemic

Association Between Hospital Adoption of an Emergency Department Treatment Pathway for Opioid Use Disorder and Patient Initiation of Buprenorphine After Discharge

“Just give them a choice”: Patients' perspectives on starting medications for opioid use disorder in the ED

Contact Info

Product

Resources

About