Yu Megan J, Hawk Kathryn
Department of Emergency Medicine Yale School of Medicine New Haven Connecticut USA.
AEM Educ Train. 2022 Jun 29;6(3):e10779. doi: 10.1002/aet2.10779. eCollection 2022 Jun.
The objective was to describe emergency medicine (EM) resident attitudes, preferences, and experiences around the knowledge and skills around the evidence-based treatment of opioid use disorder (OUD) in the emergency department (ED).
We created an online survey that was distributed by the Emergency Medicine Residents' Association research committee listserv to approximately 6600 resident physicians at all levels of EM residency training. Data were collected between June 2020 and October 2020. This 12-question voluntary, anonymous survey included questions exploring EM resident preferences and experiences around the education and exposure to the evidence-based management of patients with OUD in the ED setting. Descriptive statistics were used.
A total of 288 of 6600 invited EM residents (response rate 4.4%) from 127 different EM residency programs across 38 states in the United States, District of Columbia, and Puerto Rico completed the survey. Most respondents (165/288; 57.3%) reported that it was "very important" for emergency physicians to have training to initiate buprenorphine treatment for patients with OUD. Just under half (140/288; 48.6%) reported they have or will receive X-waiver training during residency and 46.9% (135/288) reported experience prescribing buprenorphine in the ED. The estimated proportions of EM faculty at responding residents' primary teaching hospital with an X-waiver was "most or all" (48/285; 16.8%), "about half" (23/285; 8.1%), "a handful" (79/285; 27.7%), "one or two" (33/285; 11.6%), "none" (19/285; 6.7%), or "not sure" (83/285; 29.1%).
Survey results suggest that resident emergency physicians perceive the evidence-based management of OUD to be relevant to EM residency training and are interested in receiving training on initiating medications for OUD treatment in the ED. Opportunities to improve resident education and clinical use of buprenorphine during ED residency training were identified.
本研究旨在描述急诊医学（EM）住院医师对于急诊科（ED）阿片类物质使用障碍（OUD）循证治疗的知识与技能的态度、偏好及经验。
我们创建了一项在线调查，通过急诊医学住院医师协会研究委员会的邮件列表分发给约6600名处于EM住院医师培训各阶段的住院医师。数据收集时间为2020年6月至2020年10月。这项包含12个问题的自愿匿名调查，涵盖了关于EM住院医师在ED环境中对OUD患者循证管理的教育及接触方面的偏好和经验问题。采用描述性统计方法。
在美国38个州、哥伦比亚特区和波多黎各的127个不同EM住院医师培训项目中，6600名受邀EM住院医师中有288名（回复率4.4%）完成了调查。大多数受访者（165/288；57.3%）表示，急诊医师接受为OUD患者启动丁丙诺啡治疗的培训“非常重要”。略低于半数（140/288；48.6%）的受访者称他们在住院期间已经或将会接受X豁免培训，46.9%（135/288）的受访者表示有在ED开具丁丙诺啡的经验。在回复者所在主要教学医院中，拥有X豁免的EM教员的估计比例为“大多数或全部”（48/285；16.8%）、“约一半”（23/285；8.1%）、“少数”（79/285；27.7%）、“一两个”（33/285；11.6%）、“没有”（19/285；6.7%）或“不确定”（83/285；29.1%）。
调查结果表明，急诊住院医师认为OUD的循证管理与EM住院医师培训相关，并对接受在ED启动OUD治疗药物的培训感兴趣。确定了在ED住院医师培训期间改善住院医师对丁丙诺啡的教育及临床应用的机会。
