Department of Emergency Medicine, The Warren Alpert Medical School of Brown University, 55 Claverick St, Providence, RI 02903, United States of America.
Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI 02903, United States of America.
Am J Emerg Med. 2021 Dec;50:409-412. doi: 10.1016/j.ajem.2021.08.071. Epub 2021 Aug 28.
An ED visit for opioid overdose may be a person's only contact with the medical and behavioral health care systems and is an important opportunity to reduce risk of subsequent overdose and death. While ED initiatives to engage people with opioid use disorder (OUD) are being increasingly implemented, there are significant gaps in the receipt of services at the time of the ED encounter.
This is a retrospective cohort study of an outreach pilot project providing real-time telehealth delivered buprenorphine initiation and referral to community harm reduction and addiction treatment services via a follow up telephone call to patients after an ED visit for an opioid overdose.
From January 2020 to April 2021 there were 606 patients with an ED visit for an opioid overdose eligible for a callback. Of the 606 eligible patients, 254/645 (42%) patients could be contacted and accepted service and/or treatment referrals. Fifteen patients were connected same-day to a buprenorphine prescriber for a telehealth encounter and, of connected patients, nine received a buprenorphine prescription.
A post-ED follow up telephone call protocol is an opportunity to improve treatment engagement and access to buprenorphine for patients at high risk for opioid overdose and death.
在急诊就诊的阿片类药物过量可能是一个人与医疗和行为健康护理系统的唯一接触点，也是减少后续药物过量和死亡风险的重要机会。虽然急诊部门正在越来越多地实施针对阿片类药物使用障碍（OUD）患者的接触计划，但在急诊就诊时，他们获得服务的机会存在显著差距。
这是一项回顾性队列研究，对一项外展试点项目进行了研究，该项目通过在急诊就诊后对阿片类药物过量患者进行后续电话随访，实时提供美沙酮起始治疗和向社区减少伤害和成瘾治疗服务的转介。
从 2020 年 1 月至 2021 年 4 月，有 606 名因阿片类药物过量而就诊的患者符合回拨条件。在 606 名符合条件的患者中，254/645（42%）名患者可以联系并接受服务和/或治疗转介。有 15 名患者在当天通过远程医疗与美沙酮处方医生取得联系，在取得联系的患者中，有 9 人获得了美沙酮处方。
急诊后随访电话协议是提高高危阿片类药物过量和死亡风险患者治疗参与度和获得美沙酮机会的机会。
