Department of Emergency Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Department of Emergency Medicine, Vanderbilt University, Nashville, Tennessee, USA.
Subst Use Misuse. 2021;56(4):458-463. doi: 10.1080/10826084.2021.1879144. Epub 2021 Feb 15.
Medications for Opioid Use Disorder (MOUD) are recognized as successful treatments for Opioid Use Disorder (OUD). The Emergency Department is well situated to initiate MOUD and begin the referral process. Unfortunately, uptake of this practice among Emergency Medicine (EM) physicians has been slow. EM physicians may feel inadequately prepared to provide MOUD and addiction referral services due to lack of previous training and experience. The goal of this pilot study was to create, implement, and evaluate an OUD management curriculum for EM residents and measure impact on knowledge, practice, and empathy. : A 4.5-hour curriculum was developed, incorporating the Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment mission statement as well as the Accreditation Council for Graduate Medical Education and the American Board of Emergency Medicine resident physician milestones. The curriculum was inserted into an existing EM residency didactic block at an urban, tertiary care, residency program. Surveys were obtained pre- and post-intervention. Post curriculum surveys demonstrated improved knowledge of buprenorphine/naloxone including indications, clinical effects and side-effects ( < 0.05). Surveys also noted increased comfort prescribing buprenorphine/naloxone for opioid withdrawal and misuse and instructing patients on home induction ( < 0.05). Additionally, residents responded positively regarding the impact of the curriculum on their understanding of the topic and their subsequent confidence in managing patients with OUD in the ED setting. A dedicated brief MOUD and referral curriculum can be effectively integrated into EM resident education to provide valuable clinical knowledge that may affect clinical practice.
阿片类药物使用障碍（MOUD）药物被认为是阿片类药物使用障碍（OUD）的成功治疗方法。急诊科非常适合启动 MOUD 并开始转介过程。不幸的是，急诊医学（EM）医生对此实践的接受速度很慢。由于缺乏以前的培训和经验，EM 医生可能会觉得自己没有准备好提供 MOUD 和成瘾转介服务。这项试点研究的目的是为 EM 住院医师创建、实施和评估阿片类药物使用障碍管理课程，并衡量其对知识、实践和同理心的影响。 ：开发了一个 4.5 小时的课程，其中纳入了药物滥用和心理健康服务管理局药物滥用治疗中心的使命声明，以及研究生医学教育认证委员会和美国急诊医学委员会住院医师的里程碑。该课程插入到一个城市、三级护理、住院医师培训计划的现有 EM 住院医师理论课程中。在干预前后进行了调查。 课程后的调查显示，对丁丙诺啡/纳洛酮的了解有所提高，包括适应症、临床效果和副作用（ < 0.05）。调查还指出，开处方丁丙诺啡/纳洛酮治疗阿片类药物戒断和滥用以及指导患者进行家庭诱导的舒适度增加（ < 0.05）。此外，住院医师对课程对他们对该主题的理解及其随后在 ED 环境中管理 OUD 患者的信心的影响做出了积极回应。 专门的简短 MOUD 和转介课程可以有效地纳入 EM 住院医师教育，提供有价值的临床知识，可能会影响临床实践。
