Multicomponent Strategy Increases ED-Initiated Opioid Use Disorder Tx

Emergency room entrance at night with ambulance
A multicomponent strategy provider intervention can increase initiation of buprenorphine treatment for opioid use disorder in the emergency department.

HealthDay News A multicomponent strategy provider intervention can increase initiation of buprenorphine treatment for opioid use disorder in the emergency department, according to a study published online Dec. 15 in the Annals of Emergency Medicine.

Margaret Lowenstein, M.D., from the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, and colleagues examined implementation, maintenance, and provider adoption of a multicomponent strategy for opioid use disorder treatment in 3 urban, academic emergency departments. The analysis included electronic health record data for adult patients with opioid use disorder-related visits before (March 2017 to November 2018) and after (December 2018 to July 2020) implementation (2,665 visits).

The researchers found that overall, 13% of patients received medications for opioid use disorder during or after their emergency department visit. There were sustained increases observed in treatment and process measures following intervention implementation, with a net increase in total buprenorphine of 20% in the postimplementation period. There was an immediate increase seen in the probability of buprenorphine treatment of 24.5% with intervention implementation when adjusting for patient-level factors. Provider-level buprenorphine prescribing ranged from 0 to 61% of opioid use disorder-related encounters, with 70% of providers writing at least 1 buprenorphine prescription.

“The fact that some physicians in our group were able to provide this evidence-based treatment to more than half of their patients while others had the ability to do so, but never did, showed there was much more work to be done to nudge clinicians and make offering this treatment a default process,” a coauthor said in a statement.

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