Attached is my poster for the AHSR 2021 Conference, with abstract following below in this email per the instructions. Thanks and please let me know if any changes are needed.
Treatment and navigation for patients with opioid use disorder in Delaware emergency departments
Hospital emergency departments (EDs) serve as vital touch points to engage patients in long-term treatment for opioid use disorder. Despite evidence to support ED initiation of medication treatment and navigation to outpatient care, these practices remain variable. State and federal policies may be needed to develop effective and coordinated opioid systems of care. We sought to examine barriers and facilitators to improving OUD treatment and linkage in Delaware EDs, focusing on the use of buprenorphine and peer recovery specialists (PRS).
We conducted a qualitative study using semi-structured telephone interviews with a purposive sample of physicians, care managers, and PRS in 5 Delaware EDs. We used qualitative content analysis to extract key themes from the interviews regarding current practices, resources, and gaps for ED patients with opioid use disorder, with specific questions focused on availability of buprenorphine and PRS who had been deployed to EDs through prior initiatives.
We conducted 21 interviews with physicians (n = 10), care managers (n = 3), and peer recovery specialists (n = 9) across the state. Key barriers to improving OUD treatment included: 1) lack of reliable, timely access to outpatient follow-up to support buprenorphine initation, 2) focus on placement of patients in rehabiliation or detox facilities with limited access to medication treatment, 3) complex social and medical needs for ED patients. Key facilitators included: 1) high value for PRS although roles varied significantly between EDs, 2) clinician motivation for training and potential practice change, and 3) willingness to support harm reduction practices including naloxone distribution.
State-level policies may address barriers and harness facilitators to expand OUD treatment for ED patients, particularly through supporting partnerships between EDs and facilities offering timely, reliable access to evidence-based treatment and standardizing best practices for PRS.