Chestnut Health Systems, Lighthouse Institute, 221 W. Walton St., Chicago, IL, 60610, United States.
Indiana University Richard M. Fairbanks School of Public Health, Department of Social and Behavioral Sciences, 1050 Wishard Blvd., Indianapolis, IN, 46202, United States.
Drug Alcohol Depend. 2021 Apr 1;221:108595. doi: 10.1016/j.drugalcdep.2021.108595. Epub 2021 Feb 15.
In recent years, a number of emergency department (ED)-based interventions have been developed to provide supports and/or treatment linkage for people who use opioids. However, there is limited research supporting the effectiveness of the majority of these interventions. Project POINT is an ED-based intervention aimed at providing opioid overdose survivors with naloxone and recovery supports and connecting them to evidence-based medications for opioid use disorder (MOUD). An evaluation of POINT was conducted.
A difference-in-difference analysis of electronic health record data was completed to understand the difference in outcomes for patients admitted to the ED when a POINT staff member was working versus times when they were not. The observation window was January 1, 2012 to July 6, 2019, which included N = 1462 unique individuals, of which 802 were in the POINT arm. Outcomes of focus include MOUD opioid prescriptions dispensed, active non-MOUD opioid prescriptions dispensed, naloxone access, and drug poisonings.
The POINT arm had a significant increase in MOUD prescriptions dispensed, non-MOUD prescriptions dispensed, and naloxone access (all p-values < 0.001). There was no significant effect related to subsequent drug poisoning-related hospital admissions.
The results support the assertion that POINT is meeting its two primary goals related to increasing naloxone access and connecting patients to MOUD. Generalization of these results is limited; however, the evaluation contributes to a nascent area of research and can serve a foundation for future work.
近年来，许多基于急诊部（ED）的干预措施已被开发出来，旨在为使用阿片类药物的人群提供支持和/或治疗联系。然而，大多数这些干预措施的有效性都缺乏研究支持。POINT 项目是一种基于 ED 的干预措施，旨在为阿片类药物过量幸存者提供纳洛酮和康复支持，并将他们与基于证据的阿片类药物使用障碍（MOUD）药物联系起来。对 POINT 进行了评估。
通过电子健康记录数据的差异分析，了解当 POINT 工作人员在 ED 工作时与他们不在时接受 ED 治疗的患者的结果差异。观察窗口为 2012 年 1 月 1 日至 2019 年 7 月 6 日，其中包括 N = 1462 名独特个体，其中 802 名在 POINT 组。重点关注的结果包括 MOUD 阿片类药物处方、非 MOUD 阿片类药物处方、纳洛酮的获取以及药物中毒。
POINT 组在 MOUD 处方、非 MOUD 处方和纳洛酮获取方面显著增加（所有 p 值均 < 0.001）。与随后的药物中毒相关的住院治疗没有显著效果。
结果支持这样的说法，即 POINT 正在实现其与增加纳洛酮获取和将患者与 MOUD 联系起来相关的两个主要目标。然而，这些结果的推广是有限的；但是，该评估为一个新兴的研究领域做出了贡献，并可以为未来的工作奠定基础。
