Opioid Abuse
Conditions
Brief summary
This study is a collaboration between the University of Utah and Castleview Hospital in Price, Utah. Buprenorphine is a medication approved by the FDA to treat Opioid Use Disorder (OUD). Castleview Hospital currently does not prescribe buprenorphine in the emergency department (ED) instead it refers patients to outside addiction treatment facilities. This is a service focused project which the University of Utah will provide mentoring and education to Castleview in implementing an in ED buprenorphine/naloxone distribution program along with referral to continued services. After the program has been implemented, the investigators will evaluate it using quantitative surveys of program participants and qualitative interviews of hospital staff and stakeholders.
Detailed description
Among health care environments, ED often are the front lines of care for those with OUD or who experience opioid overdose. The University of Utah Hospital ED has the Bridge Program which provides buprenorphine and naloxone with warm-hand off referral for continued treatment to people presenting with OUD. In order to extend the services offered by the Bridge Program to rural hospitals, the investigators will be providing mentoring and education to Castleview Hospital in establishing a similar program. Castleview Hospital is the only acute care hospital that serves Carbon and Emery counties, which outside of the Salt Lake City metro area have the highest opioid overdose rates in the State of Utah. This project will utilize both quantitative and qualitative measures to evaluate the impact of this program on patients, hospital staff, and community members.
Interventions
BEHAVIORALImplementation of the BINDeR-Tx service model
ED-initiated buprenorphine, discharge with naloxone, and warm-hand off referral for continued treatment for individuals with OUD. This is considered standard treatment at the University of Utah ED. In order to extend these services to rural hospitals this study will be assisting Castleview Hospital to establish a similar program.
Sponsors
Jerry Cochran
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
For qualitative interviews with providers, administrators, stakeholders: * Must be affiliated with Castleview Hospital as a provider, administrator or stakeholder. For the quantitative surveys: * Must be a Castleview Hospital patient who receives the BINDeR-Tx model.
Exclusion criteria
For qualitative interviews with providers, administrators, stakeholders: * Not familiar with the BINDeR-Tx model * No interaction with the BINDeR-Tx model For the quantitative surveys: * Unable to speak and read English * Subject is unable to provide contact information
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Patient Focused: Number of patients receiving services. | 24 months | Will be the aggregate number of individuals who received ED-initiated buprenorphine. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Living Conditions | enrollment and 6 months post enrollment | Living conditions will be measured using the GPRA questions on residence within the past 30 days. |
| Implementation and service quality: Satisfaction with projected service | 24 months. | Qualitative interviews including clinicians, hospital staff, and community members associated with Castleview Hospital will be the investigators using the Consolidated Framework for Implementation Research (CFIR). |
| Implementation and service quality: Patient satisfaction | enrollment and 6 months post enrollment | Patient satisfaction will be assessed using the Patient Satisfaction Questionnaire Short Form (PSQ-18) |
| Substance use diagnosis and treatment | enrollment and 6 months post enrollment | Using the Government Performance and Results Act (GPRA) Outcome questions on substance use within the past 30 days, other substance use disorder diagnoses and treatment in the past 30 days, and mental health diagnoses. |
| Social Connectedness | enrollment and 6 months post enrollment | Social connectedness will be measured using the GPRA questions on mutual support group attendance in the last 30 days and relationship satisfaction and support. |
| Mental and Physical Health Problems and Treatment/Recovery | enrollment and 6 months post enrollment | Mental and physical health problems and treatment/recovery will be measured using the GPRA questions on mental health symptoms and medical care received in the past 30 days and insurance status. |
| Legal Status | enrollment and 6 months post enrollment | Legal status will be measured using the GPRA questions on incarceration in the past 30 days, charges, trial, sentencing, parole, probation, and drug court status. |
| Discharge status | enrollment and 6 months post enrollment | Discharge status will be measured using the GRPA questions on substance use diagnosis and treatment in the past 30 days. |
| Follow-up Status | enrollment and 6 months post enrollment | Follow-up status will be measured using the GPRA questions on contact and follow-up status. |
| Education, Employment, and Income | enrollment and 6 months post enrollment | Education, employment, and income will be measured using the GPRA questions on education level, employment status, living expenses and income status. |
Countries
United States
Outcome results
None listed