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一项旨在改善急诊医学住院医师对阿片类药物使用障碍患者治疗的教育干预措施的影响。

The Impact of an Educational Intervention to Improve Emergency Medicine Resident Treatment of Individuals With Opioid Use Disorder.

作者信息

Hazekamp Corey S, Chang Bernard P, Scoccimarro Anthony D, West Jason R, Sacco Dana L

机构信息

Department of Emergency Medicine, NYC Health + Hospitals/Lincoln, Bronx, New York, USA.

Department of Emergency Medicine, Columbia University Irving Medical Center, New York, New York, USA.

出版信息

J Am Coll Emerg Physicians Open. 2025 May 5;6(3):100157. doi: 10.1016/j.acepjo.2025.100157. eCollection 2025 Jun.

Abstract

OBJECTIVES

Introducing evidence-based treatment strategies into education for emergency medicine (EM) residents might improve treatment for people with opioid use disorder (OUD). Our objective was to evaluate the impact of an educational initiative in treating OUD with emergency department (ED)-initiated buprenorphine.

METHODS

This was a retrospective analysis of an educational initiative using case-based discussions to train EM residents in the treatment of OUD, including ED-initiated buprenorphine, at a single EM residency program. Patients at the corresponding ED who were given an OUD-related diagnosis were screened for the initiation of buprenorphine. We calculated the odds of receiving ED-initiated buprenorphine among eligible patients 6 months before and 6 months after the educational initiative. Patients currently treated with buprenorphine or methadone were excluded from the analysis.

RESULTS

Before the educational initiative, 14% (26/186) of patients with OUD eligible for buprenorphine underwent a novel buprenorphine induction in the ED, which increased to 18% (33/183) after the educational initiative. Following the educational initiative, the odds of receiving ED-initiated buprenorphine compared with the pre-educational initiative was 1.35 (95% CI, 0.77-2.24).

CONCLUSION

The total number of people with OUD treated with buprenorphine increased after our educational initiative, but the odds ratio was not statistically significant. Complementing educational initiatives, other factors are likely needed to significantly increase the likelihood that a person with OUD is treated with buprenorphine.

摘要

目的

将循证治疗策略引入急诊医学(EM)住院医师教育中,可能会改善对阿片类物质使用障碍(OUD)患者的治疗。我们的目的是评估一项教育倡议对使用急诊科(ED)启动的丁丙诺啡治疗OUD的影响。

方法

这是一项对一项教育倡议的回顾性分析,该倡议通过基于病例的讨论来培训EM住院医师治疗OUD,包括在单一的EM住院医师培训项目中使用ED启动的丁丙诺啡。对在相应急诊科被诊断为与OUD相关的患者进行丁丙诺啡启动筛查。我们计算了教育倡议前6个月和后6个月符合条件的患者中接受ED启动丁丙诺啡治疗的几率。目前正在接受丁丙诺啡或美沙酮治疗的患者被排除在分析之外。

结果

在教育倡议之前,14%(26/186)符合丁丙诺啡治疗条件的OUD患者在急诊科接受了新型丁丙诺啡诱导治疗,在教育倡议之后这一比例增加到了18%(33/183)。在教育倡议之后,与教育倡议之前相比,接受ED启动丁丙诺啡治疗的几率为1.35(95%置信区间,0.77 - 2.24)。

结论

在我们的教育倡议之后,接受丁丙诺啡治疗的OUD患者总数有所增加,但优势比无统计学意义。除教育倡议外,可能还需要其他因素来显著提高OUD患者接受丁丙诺啡治疗的可能性。

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