Continuation of outpatient buprenorphine therapy after dispensing Buprenorphine-Naloxone from the emergency department. (3rd April 2022)

• Record Type: Journal Article
• Authors: Krenz, James R.; Hayes, Bryan D.; Wakeman, Sarah E.; Martin, Alister; Raja, Ali S.; White, Benjamin A.; Koehl, Jennifer L.
• Is Part Of: Clinical toxicology. Volume 60:Number 4(2022)
• Page Start: 429
• Page End: 432
• Publication Date: 2022-04-03
• Subjects: Buprenorphine -- substance use disorder -- opioid use disorder -- emergency department; Toxicology -- Periodicals; Toxicological emergencies -- Periodicals; 615.9
• DOI: 10.1080/15563650.2021.1968421
• Languages: English
• ISSNs: 1556-3650

Abstract

Abstract: Background: Patients with opioid use disorder (OUD) are frequently seen in the ED for opioid-related reasons, which creates an opportunity for ED providers to discuss medications for OUD with their patients. Buprenorphine is a partial mu-opioid agonist that is FDA approved to treat OUD and may be initiated in the ED. Traditionally, buprenorphine therapy was initiated under healthcare provider observation; however, other strategies such as at-home induction have also emerged. Methods: This was a retrospective descriptive analysis of patients aged 18 years or older who received a take-home supply of buprenorphine-naloxone from an urban, academic ED between March 2018 and March 2020. The primary outcome was the proportion of patients who filled a prescription for buprenorphine at three months after index ED visit. The proportion of patients that filled a prescription for buprenorphine at six months was also evaluated. The primary safety endpoint was the proportion of patients with return ED visit within six months related to opioid overdose. Results: There were 242 patient records reviewed with 155 patients included in final analysis. Seventy (45.2%) patients filled buprenorphine prescriptions at three months, with 64 (41.3%) who filled buprenorphine prescriptions at six months. Seventeen (11%) patients had a return ED visit related to opioid overdose within six months. Conclusion: Dispensing buprenorphine take-home kits from the ED resulted in continuation of outpatient buprenorphine in almost 50% of patients. Further studies are warranted to define the role of ED-dispensed buprenorphine.