Evaluation of an emergency department-based opioid overdose survivor intervention: Difference-in-difference analysis of electronic health record data to assess key outcomes. (1st April 2021)

• Record Type: Journal Article
• Authors: Watson, Dennis P.; Weathers, Tess; McGuire, Alan; Cohen, Alex; Huynh, Philip; Bowes, Clay; O'Donnell, Daniel; Brucker, Krista; Gupta, Sumedha
• Is Part Of: Drug and alcohol dependence. Volume 221(2021)
• Publication Date: 2021-04-01
• Subjects: ED emergency department -- MOUD Medication for opioid use disorder -- NDC National Drug Code -- OUD opioid use disorder -- POINT Project Planned Outreach, Intervention, Naloxone, and Treatment; Opioid use disorder -- Medication for opioid use disorder -- Peer recovery coaching -- Emergency medicine -- Overdose -- Naloxone -- Evaluation -- Difference-in-difference; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2021.108595
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: ED-based opioid use disorder treatment linkage interventions are scaling. There is limited evidence for linkage interventions without buprenorphine induction. An evaluation of such an intervention, Project POINT, was conducted. The POINT arm had significantly better treatment linkage and naloxone dispensation. There was no improvement in subsequent poisoning-based hospital admissions. Abstract: Background: In recent years, a number of emergency department (ED)-based interventions have been developed to provide supports and/or treatment linkage for people who use opioids. However, there is limited research supporting the effectiveness of the majority of these interventions. Project POINT is an ED-based intervention aimed at providing opioid overdose survivors with naloxone and recovery supports and connecting them to evidence-based medications for opioid use disorder (MOUD). An evaluation of POINT was conducted. Methods: A difference-in-difference analysis of electronic health record data was completed to understand the difference in outcomes for patients admitted to the ED when a POINT staff member was working versus times when they were not. The observation window was January 1, 2012 to July 6, 2019, which included N = 1462 unique individuals, of which 802 were in the POINT arm. Outcomes of focus include MOUD opioid prescriptions dispensed, active non-MOUD opioid prescriptions dispensed, naloxone access, and drug poisonings. Results: The POINT arm had a significant increase in MOUD prescriptions dispensed, non-MOUD prescriptions dispensed, and naloxone access (all p-values < 0.001). There was no significant effect related to subsequent drug poisoning-related hospital admissions. Conclusions: The results support the assertion that POINT is meeting its two primary goals related to increasing naloxone access and connecting patients to MOUD. Generalization of these results is limited; however, the evaluation contributes to a nascent area of research and can serve a foundation for future work.