Retention in Treatment after Emergency Department-Initiated Buprenorphine

Author(s):  
Lindsey K. Jennings ◽  
Suzanne Lane ◽  
Jenna McCauley ◽  
Angela Moreland ◽  
Karen Hartwell ◽  
...  
2021 ◽  
Author(s):  
Caleb Carroll ◽  
Delissa Hand ◽  
Whitney Covington ◽  
Joel Rodgers ◽  
Lauren A. Walter

Abstract Background: Emergency department (ED)-initiated medications for opioid use disorder (MOUD) have emerged as an effective strategy against the opioid epidemic. Opioid use disorder (OUD) patients engaged in ED-initiated MOUD programs have higher retention in treatment programs and improved outcomes with regard to overdose rates and mortality. It is unclear however, how engagement in ED-initiated MOUD programs might affect quality of life (QoL). We sought to describe demographic characteristics and QoL factors reported by patients engaged in ED-initiated MOUD and referral services. Methods: An ED MOUD-initiation program was launched in July 2019, with subsequent referral to definitive services. Enrolled patients were interviewed at intake, 3-months, and 6-months to ascertain QoL indices via the Government Performance and Results Act (GPRA) measures. Descriptive statistics and Fisher’s Exact were utilized to assess the data. Results: Through 12/2020, 89 participants were enrolled. The majority were white (85.4%), male (61.8%), and between the ages of 25-44 (75.3%). To-date, 31 participants (43.7% eligible) have completed 3-month follow-up and 28 (45.2% eligible) have competed 6-month follow-up. With regards to assessed QoL factors, over half demonstrated significant improvement, including 5 of 7 psychosocial factors, to include satisfaction with personal relationships, QoL self-rating, satisfaction with personal health, energy for everyday life, and satisfaction with self (p <.05). Financial needs met was the only objective QoL factor to demonstrate significant improvement during the follow-up time period. While not significant, homelessness also decreased, specifically 14 (15.7%) identified as homeless at intake as compared to one (3.7%) at 6-month follow-up. Additional trends toward decreased violence exposure and increased employment rates were also noted.Conclusions: In addition to decreasing illicit opioid drug use, maintenance of ED-initiated MOUD may positively impact broad QoL measures.


Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 155-160 ◽  
Author(s):  
Jin Kim ◽  
Han Joon Kim ◽  
Soo Hyun Kim ◽  
Sang Hoon Oh ◽  
Kyu Nam Park

Abstract. Background: Previous suicide attempts increase the risk of a completed suicide. However, a large proportion of patients with deliberate self-wrist cutting (DSWC) are often discharged without undergoing a psychiatric interview. Aims: The aims of this study were to investigate the differences in the characteristics and outcomes of patients with DSWC and those with deliberate self-poisoning (DSP) episodes. The results of this study may be used to improve the efficacy of treatment for DSWC patients. Method: We retrospectively reviewed the medical records of 598 patients with DSWC and DSP who were treated at the emergency department of Seoul Saint Mary's Hospital between 2008 and 2013. We assessed sociodemographic information, clinical variables, the reasons for the suicide attempts, and the severity of the suicide attempts. Results: A total of 141 (23.6%) patients were included in the DSWC group, and 457 (76.4%) were included in the DSP group. A significantly greater number of patients in the DSWC group had previously attempted suicide (p = .014). A total of 63 patients (44.7%) in the DSWC group and 409 patients (89.5%) in the DSP group underwent psychiatric interviews. Conclusion: More DSWC patients had previously attempted suicide, but fewer of them underwent psychiatric interviews compared with the DSP patients.


Crisis ◽  
2014 ◽  
Vol 35 (6) ◽  
pp. 406-414 ◽  
Author(s):  
Raimondo Maria Pavarin ◽  
Angelo Fioritti ◽  
Francesca Fontana ◽  
Silvia Marani ◽  
Alessandra Paparelli ◽  
...  

Background: The international literature reports that for every completed suicide there are between 8 and 22 visits to an Emergency Department (ED) for attempted suicide/suicidal behavior. Aims: To describe the characteristics of admission to emergency departments (EDs) for suicide-related presenting complaints in the metropolitan area of Bologna; to estimate the risk for all-cause mortality and for suicide; to identify the profiles of subjects most at risk. Method: Follow-up of patients admitted to the EDs of the metropolitan area of Bologna between January 2004 and December 2010 for attempted suicide. A Cox model was used to evaluate the association between sociodemographic variables and the general mortality risk. Results: We identified 505 cases of attempted suicide, which were more frequent for female subjects, over the weekend, and at night (8:00 p.m./8:00 a.m.). The most used suicide methods were psychotropic drugs, sharp or blunt objects, and jumping from high places. In this cohort, 3.6% of subjects completed suicide (4.5% of males vs. 2.9% of females), 2.3% within 1 year of the start of follow-up. The most common causes of death were drug use and hanging. In the multivariate analysis, those who used illicit drugs 24 hr prior to admission to the ED (hazard ratio [HR] = 3.46, 95% CI = 1.23–9.73) and patients who refused the treatment (HR = 6.74, 95% CI = 1.86–24.40) showed an increased mortality risk for suicide. Conclusion: Deliberate self-harm patients presenting to the ED who refuse treatment represent a specific target group for setting up dedicated prevention schemes.


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