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{
    "pk": 12927,
    "title": "Emergency Department Clinicians’ Attitudes Toward Opioid Use Disorder and Emergency Department-initiated Buprenorphine Treatment: A Mixed-Methods Study",
    "subtitle": null,
    "abstract": "Introduction: \nEmergency department (ED) visits related to opioid use disorder (OUD) have increased nearly twofold over the last decade. Treatment with buprenorphine has been demonstrated to decrease opioid-related overdose deaths. In this study, we aimed to better understand ED clinicians’ attitudes toward the initiation of buprenorphine treatment in the ED.\nMethods:\n We performed a mixed-methods study consisting of a survey of 174 ED clinicians (attending physicians, residents, and physician assistants) and semi-structured interviews with 17 attending emergency physicians at a tertiary-care academic hospital.\nResults:\n A total of 93 ED clinicians (53% of those contacted) completed the survey. While 80% of respondents agreed that buprenorphine should be administered in the ED for patients requesting treatment, only 44% felt that they were prepared to discuss medication for addiction treatment. Compared to clinicians with fewer than five years of practice, those with greater experience were less likely to approve of ED-initiated buprenorphine. In our qualitative analysis, physicians had differing perspectives on the role that the ED should play in treating OUD. Most physicians felt that a buprenorphine-based intervention in the ED would be feasible with institutional support, including training opportunities, protocol support within the electronic health record, counseling and support staff, and a robust referral system for outpatient follow-up.\nConclusion: \nED clinicians’ perception of buprenorphine varied by years of practice and training level. Most ED clinicians did not feel prepared to initiate buprenorphine in the ED. Qualitative interviews identified several addressable barriers to ED-initiated buprenorphine.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Opioid use disorder, buprenorphine, medication for addiction treatment, suboxone"
        }
    ],
    "section": "Behavioral Health",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/2ww85533",
    "frozenauthors": [
        {
            "first_name": "Dana",
            "middle_name": "D.",
            "last_name": "Im",
            "name_suffix": "",
            "institution": "Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts;\nBrigham and Women’s Hospital, Department of Emergency Medicine, Boston, Massachusetts",
            "department": "None"
        },
        {
            "first_name": "Anita",
            "middle_name": "",
            "last_name": "Chary",
            "name_suffix": "",
            "institution": "Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts;\nBrigham and Women’s Hospital, Department of Emergency Medicine, Boston, Massachusetts \n\nDepartment of Emergency Medicine\nBrigham and Women’s Hospital\n75 Francis Street, NH-2\nBoston, MA 02115, USA",
            "department": "None"
        },
        {
            "first_name": "Anna",
            "middle_name": "L.",
            "last_name": "Condella",
            "name_suffix": "",
            "institution": "Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts;\nBrigham and Women’s Hospital, Department of Emergency Medicine, Boston, Massachusetts \n\nDepartment of Emergency Medicine\nBrigham and Women’s Hospital\n75 Francis Street, NH-2\nBoston, MA 02115, USA",
            "department": "None"
        },
        {
            "first_name": "Hurnan",
            "middle_name": "",
            "last_name": "Vongsachang",
            "name_suffix": "",
            "institution": "University of Southern California, Keck School of Medicine, Department of Emergency Medicine, Los Angeles, California",
            "department": "None"
        },
        {
            "first_name": "Lucas",
            "middle_name": "C.",
            "last_name": "Carlson",
            "name_suffix": "",
            "institution": "Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts;\nBrigham and Women’s Hospital, Department of Emergency Medicine, Boston, Massachusetts \n\nDepartment of Emergency Medicine\nBrigham and Women’s Hospital\n75 Francis Street, NH-2\nBoston, MA 02115, USA",
            "department": "None"
        },
        {
            "first_name": "Lara",
            "middle_name": "",
            "last_name": "Vogel",
            "name_suffix": "",
            "institution": "Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts;\nBrigham and Women’s Hospital, Department of Emergency Medicine, Boston, Massachusetts \nDepartment of Emergency Medicine\nBrigham and Women’s Hospital\n75 Francis Street, NH-2\nBoston, MA 02115, USA",
            "department": "None"
        },
        {
            "first_name": "Alister",
            "middle_name": "",
            "last_name": "Martin",
            "name_suffix": "",
            "institution": "Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts;\nBrigham and Women’s Hospital, Department of Emergency Medicine, Boston, Massachusetts \n\nDepartment of Emergency Medicine\nBrigham and Women’s Hospital\n75 Francis Street, NH-2\nBoston, MA 02115, USA",
            "department": "None"
        },
        {
            "first_name": "Nathan",
            "middle_name": "",
            "last_name": "Kunzler",
            "name_suffix": "",
            "institution": "Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts;\nBrigham and Women’s Hospital, Department of Emergency Medicine, Boston, Massachusetts \n\nDepartment of Emergency Medicine\nBrigham and Women’s Hospital\n75 Francis Street, NH-2\nBoston, MA 02115, USA",
            "department": "None"
        },
        {
            "first_name": "Scott",
            "middle_name": "G.",
            "last_name": "Weiner",
            "name_suffix": "",
            "institution": "Brigham and Women’s Hospital, Department of Emergency Medicine, Boston, Massachusetts",
            "department": "None"
        },
        {
            "first_name": "Margaret",
            "middle_name": "",
            "last_name": "Samuels-Kalow",
            "name_suffix": "",
            "institution": "Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts",
            "department": "None"
        }
    ],
    "date_submitted": "2019-07-08T22:43:03Z",
    "date_accepted": "2019-07-08T22:43:03Z",
    "date_published": "2020-02-21T22:33:45Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/12927/galley/6790/download/"
        }
    ]
}