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{
    "pk": 14847,
    "title": "Healthcare Use After Buprenorphine Prescription in a Community Emergency Department: A Cohort Study",
    "subtitle": null,
    "abstract": "Introduction:\n Recent studies from urban academic centers have shown the promise of emergency physician-initiated buprenorphine for improving outcomes in opioid use disorder (OUD) patients. We investigated whether emergency physician-initiated buprenorphine in a rural, community setting decreases subsequent healthcare utilization for OUD patients. \nMethods:\n We performed a retrospective chart review of patients presenting to a community hospital emergency department (ED) who received a prescription for buprenorphine from June 15, 2018–June 15, 2019. Demographic and opioid-related International Classification of Diseases, 10th Revision, (ICD-10) codes were documented and used to create a case-matched control cohort of demographically matched patients who presented in a similar time frame with similar ICD-10 codes but did not receive buprenorphine. We recorded 12-month rates of ED visits, all-cause hospitalizations, and opioid overdoses. Differences in event occurrences between groups were assessed with Poisson regression. \nResults:\n Overall 117 patients were included in the study: 59 who received buprenorphine vs 58 controls. The groups were well matched, both roughly 90% White and 60% male, with an average age of 33.4 years for both groups. Controls had a median two ED visits (range 0-33), median 0.5 hospitalizations (range 0-8), and 0 overdoses (range 0-3), vs median one ED visit (range 0-8), median 0 hospitalizations (range 0-4), and median 0 overdoses (range 0-3) in the treatment group. The incidence rate ratio (IRR) for counts of ED visits was 0.61, 95% confidence interval (CI), 0.49, 0.75, favoring medication-assisted treatment (MAT). For hospitalizations, IRR was 0.34, 95% CI, 0.22, 0.52 favoring MAT, and for overdoses was 1.04, 95% CI, 0.53, 2.07. \nConclusion:\n Initiation of buprenorphine by ED providers was associated with lower 12-month ED visit and all-cause hospitalization rates with comparable overdose rates compared to controls. These findings show the ED’s potential as an initiation point for medication-assisted treatment in OUD patients.",
    "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": "Drug Abuse, Medication Assisted Treatment, Health Care Utilization"
        }
    ],
    "section": "Behavioral Health",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/2242b26v",
    "frozenauthors": [
        {
            "first_name": "Tinh",
            "middle_name": "",
            "last_name": "Le",
            "name_suffix": "",
            "institution": "Case Western Reserve University School of Medicine, Cleveland, Ohio",
            "department": "None"
        },
        {
            "first_name": "Parker",
            "middle_name": "",
            "last_name": "Cordial",
            "name_suffix": "",
            "institution": "The Ohio State University College of Medicine, Columbus, Ohio",
            "department": "None"
        },
        {
            "first_name": "Mackenzie",
            "middle_name": "",
            "last_name": "Sankoe",
            "name_suffix": "",
            "institution": "Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio",
            "department": "None"
        },
        {
            "first_name": "Charlotte",
            "middle_name": "",
            "last_name": "Purnode",
            "name_suffix": "",
            "institution": "Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio",
            "department": "None"
        },
        {
            "first_name": "Ankur",
            "middle_name": "",
            "last_name": "Parekh",
            "name_suffix": "",
            "institution": "The Ohio State University, Columbus, Ohio",
            "department": "None"
        },
        {
            "first_name": "Thomas",
            "middle_name": "",
            "last_name": "Baker",
            "name_suffix": "",
            "institution": "Genesis Healthcare System, Department of Emergency Medicine, Zanesville, Ohio",
            "department": "None"
        },
        {
            "first_name": "Brian",
            "middle_name": "",
            "last_name": "Hiestand",
            "name_suffix": "",
            "institution": "Wake Forest School of Medicine, Department of Emergency Medicine, Winston-Salem, North Carolina",
            "department": "None"
        },
        {
            "first_name": "W.F.",
            "middle_name": "",
            "last_name": "Peacock",
            "name_suffix": "",
            "institution": "Baylor College of Medicine, Department of Emergency Medicine, Houston, Texas",
            "department": "None"
        },
        {
            "first_name": "James",
            "middle_name": "",
            "last_name": "Neuenschwander",
            "name_suffix": "",
            "institution": "The Ohio State University College of Medicine, Columbus, Ohio; Genesis Healthcare System, Department of Emergency Medicine, Zanesville, Ohio",
            "department": "None"
        }
    ],
    "date_submitted": "2020-12-24T21:03:33+05:30",
    "date_accepted": "2020-12-24T21:03:33+05:30",
    "date_published": "2021-09-25T01:47:20+05:30",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/14847/galley/7542/download/"
        }
    ]
}