Center for Healing, Division of Addiction Medicine, Cooper University Health Care, Camden, New Jersey, USA.
Department of Psychology, Rowan University, Camden, New Jersey, USA.
Acad Emerg Med. 2024 Jun;31(6):576-583. doi: 10.1111/acem.14880. Epub 2024 Feb 15.
Emergency departments (EDs) are a critical point of entry into treatment for patients struggling with opioid use disorder (OUD). When initiated in the ED, buprenorphine is associated with increased addiction treatment engagement at 30 days when initiated. Despite this association, it has had slow adoption. The barriers to ED buprenorphine utilization are well documented; however, the benefits of prescribing buprenorphine for emergency physicians (EPs) have not been explored. This study utilized semistructured interviews to explore and understand how EPs perceive their experiences working in EDs that have successfully implemented ED bridge programs (EDBPs) for patients with OUD.
Semistructured interviews were conducted with EPs from four geographically diverse academic hospitals with established EDBPs. Interviews were recorded and transcribed, and emergent themes were identified using codebook thematic analysis. Analysis credibility and transparency were confirmed with peer debriefing.
Twenty-two interviews were conducted across the four sites. Three key themes were constructed during the analyses: (1) provided EPs agency; (2) transformed EPs' emotions, attitudes, and behaviors related to treating patients with OUD; and (3) improved EPs' professional quality of life.
Participants in this study reported several common themes related to participation in their hospital's BP. Overall our results suggest that physicians who participate in EDBPs may feel a renewed sense of fulfillment and purpose in their personal and professional lives. These positive changes may lead to increased job satisfaction in hospitals that have successfully launched EDBP.
急诊科是治疗阿片类药物使用障碍（OUD）患者的关键切入点。在急诊科开始使用丁丙诺啡时，与 30 天内开始使用相比，与增加的成瘾治疗参与度相关。尽管存在这种关联，但它的采用速度仍然很慢。急诊科使用丁丙诺啡的障碍有据可查；然而，为急诊医师（EP）开丁丙诺啡的好处尚未得到探索。本研究利用半结构化访谈，探讨和了解 EPs 如何看待他们在成功实施 OUD 患者急诊科桥接项目（EDBP）的急诊科工作的经验。
对来自四个地理位置不同的学术医院的 EPs 进行了半结构化访谈，这些医院都有成熟的 EDBP。访谈进行了录音和转录，并使用编码主题分析识别出新兴主题。通过同行讨论来确认分析的可信度和透明度。
在四个地点共进行了 22 次访谈。在分析过程中构建了三个关键主题：（1）为 EPs 提供代理；（2）改变 EPs 对待 OUD 患者的情绪、态度和行为；（3）提高 EPs 的专业生活质量。
本研究的参与者报告了与参与他们医院的 BP 相关的几个共同主题。总的来说，我们的研究结果表明，参与 EDBP 的医生可能会在个人和职业生活中重新感到满足和有目标。这些积极的变化可能会导致在成功推出 EDBP 的医院中提高工作满意度。
