How emergency departments are responding to the opioid crisis: Results from a statewide survey in Kentucky.

IF 3.7 2区医学 Q1 SUBSTANCE ABUSE

Addiction Science & Clinical Practice Pub Date : 2024-11-08 DOI:10.1186/s13722-024-00512-3

Olivia K Sugarman, Samantha J Harris, Lauren Byrne, Vivian Flanagan, Sabrina Gattine, Isha Desai, Omeid Heidari, Jason B Gibbons, Sara Whaley, David Lucas, Tracy Pugh, Allison McBride, Brendan Saloner

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引用次数: 0

Abstract

Objective: There is a rising effort for hospital emergency departments (EDs) to offer and expand substance use disorder (SUD) services. This state-wide evaluation studies SUD services offered along the continuum of implementation across Kentucky's EDs to inform future state efforts to build ED bridge programs.

Methods: We conducted a mixed-methods study using an online survey of all Kentucky Emergency Department Directors between January and May of 2023. We created a hospital-level dataset which we used to summarize quantitative questions and thematically analyze open-ended responses.

Results: Our sample included 85 unique respondents (89% of all eligible Kentucky hospitals). Nine (11%) had active bridge programs to initiate opioid use disorder patients on buprenorphine. Respondents reported that the most challenging SUD-related services for EDs to implement were buprenorphine induction for opioid use disorder treatment (n = 36, 42%), referrals to community-based providers (n = 34, 40%), and providing social work services (n = 25, 29%). Respondents noted that the implementation and improvement of screening protocols were needed to better identify patients with SUD, expressed concerns about care continuity, and explicitly conveyed the need and desire for additional supports to provide SUD care.

Conclusions: The landscape of Kentucky's ED SUD supports shows several hospitals that offer services along the continuum of SUD care, and highlights the importance of technical assistance and financial resources to ensure the continuum is broadly available. Kentucky's experience speaks to broader national challenges in supporting SUD in EDs - specifically the need for financial resources, buy-in and education, and creating referral relationships to ensure care continuity.

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急诊科如何应对阿片类药物危机：肯塔基州全州调查的结果。

目的：医院急诊科（ED）提供并扩大药物使用障碍（SUD）服务的努力正在不断增加。这项全州范围的评估研究了肯塔基州急诊科在连续实施过程中提供的药物使用障碍服务，为今后该州建立急诊科桥梁计划提供参考：我们在 2023 年 1 月至 5 月期间对肯塔基州所有急诊科主任进行了在线调查，从而开展了一项混合方法研究。我们创建了一个医院级别的数据集，用于总结定量问题并对开放式回答进行主题分析：我们的样本包括 85 位独特的受访者（占所有符合条件的肯塔基州医院的 89%）。其中九家医院（11%）实施了积极的过渡计划，让阿片类药物使用障碍患者开始接受丁丙诺啡治疗。受访者称，对于急诊科而言，实施与 SUD 相关的服务最具挑战性的是丁丙诺啡诱导治疗阿片类药物使用障碍（36 人，42%）、转诊至社区医疗机构（34 人，40%）以及提供社工服务（25 人，29%）。受访者指出，需要实施和改进筛查协议，以更好地识别 SUD 患者，他们对护理的连续性表示担忧，并明确表示需要和希望获得更多支持，以提供 SUD 护理：肯塔基州的急诊室 SUD 支持情况显示，有几家医院提供 SUD 连续性护理服务，并强调了技术援助和财政资源对于确保广泛提供连续性护理的重要性。肯塔基州的经验说明了在 ED 中支持 SUD 所面临的更广泛的国家挑战，特别是需要财政资源、支持和教育，以及建立转诊关系以确保护理的连续性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Addiction Science & Clinical Practice Psychology-Clinical Psychology

CiteScore

3.90

自引率

10.80%

发文量

审稿时长

28 weeks

期刊介绍： Addiction Science & Clinical Practice provides a forum for clinically relevant research and perspectives that contribute to improving the quality of care for people with unhealthy alcohol, tobacco, or other drug use and addictive behaviours across a spectrum of clinical settings. Addiction Science & Clinical Practice accepts articles of clinical relevance related to the prevention and treatment of unhealthy alcohol, tobacco, and other drug use across the spectrum of clinical settings. Topics of interest address issues related to the following: the spectrum of unhealthy use of alcohol, tobacco, and other drugs among the range of affected persons (e.g., not limited by age, race/ethnicity, gender, or sexual orientation); the array of clinical prevention and treatment practices (from health messages, to identification and early intervention, to more extensive interventions including counseling and pharmacotherapy and other management strategies); and identification and management of medical, psychiatric, social, and other health consequences of substance use. Addiction Science & Clinical Practice is particularly interested in articles that address how to improve the quality of care for people with unhealthy substance use and related conditions as described in the (US) Institute of Medicine report, Improving the Quality of Healthcare for Mental Health and Substance Use Conditions (Washington, DC: National Academies Press, 2006). Such articles address the quality of care and of health services. Although the journal also welcomes submissions that address these conditions in addiction speciality-treatment settings, the journal is particularly interested in including articles that address unhealthy use outside these settings, including experience with novel models of care and outcomes, and outcomes of research-practice collaborations. Although Addiction Science & Clinical Practice is generally not an outlet for basic science research, we will accept basic science research manuscripts that have clearly described potential clinical relevance and are accessible to audiences outside a narrow laboratory research field.