The Impact of an Educational Intervention to Improve Emergency Medicine Resident Treatment of Individuals With Opioid Use Disorder.

Objectives: Introducing evidence-based treatment strategies into education for emergency medicine (EM) residents might improve treatment for people with opioid use disorder (OUD). Our objective was to evaluate the impact of an educational initiative in treating OUD with emergency department (ED)-initiated buprenorphine.

Methods: This was a retrospective analysis of an educational initiative using case-based discussions to train EM residents in the treatment of OUD, including ED-initiated buprenorphine, at a single EM residency program. Patients at the corresponding ED who were given an OUD-related diagnosis were screened for the initiation of buprenorphine. We calculated the odds of receiving ED-initiated buprenorphine among eligible patients 6 months before and 6 months after the educational initiative. Patients currently treated with buprenorphine or methadone were excluded from the analysis.

Results: Before the educational initiative, 14% (26/186) of patients with OUD eligible for buprenorphine underwent a novel buprenorphine induction in the ED, which increased to 18% (33/183) after the educational initiative. Following the educational initiative, the odds of receiving ED-initiated buprenorphine compared with the pre-educational initiative was 1.35 (95% CI, 0.77-2.24).

Conclusion: The total number of people with OUD treated with buprenorphine increased after our educational initiative, but the odds ratio was not statistically significant. Complementing educational initiatives, other factors are likely needed to significantly increase the likelihood that a person with OUD is treated with buprenorphine.