TOPLINE:
Implementing the Opioid Overdose Recovery Program (OORP) in emergency departments (EDs) boosts medication for opioid use disorder ( MOUD) initiation and reduces repeat overdoses, with varying outcomes across hospitals.
METHODOLOGY:
- Researchers performed an intention-to-treat retrospective cohort study to examine the impact of ED-based peer support, specifically the OORP, on addiction treatment initiation, repeat overdose, and acute care utilization.
- They analyzed the New Jersey Medicaid data of 12,046 Medicaid enrollees (age, 18-64 years; 62.0% men) who were treated for nonfatal opioid overdose across 70 acute care hospitals between January 2015 and June 2020.
- The study compared 180-day outcomes between patients treated in OORP hospitals (intervention group) and those treated in non-OORP hospitals (comparison group).
- Adjustments were made for patient characteristics, comorbidities, prior services, community demographics, and drug treatment access.
- The primary outcome was MOUD initiation within 60 days of discharge from the index overdose visit.
TAKEAWAY:
- In the intervention vs the comparison group, the mean probability of 60-day MOUD initiation was lower before implementation (0.075 vs 0.080) and higher after OORP implementation (0.121 vs 0.102).
- After 6 months of implementation, the probability of 60-day MOUD initiation increased by 0.034, representing a 45% rise from the pre-implementation average probability of 0.075.
- There was a decrease in the number of repeat overdoses in the fourth half-year (−0.086; 95% CI, −0.154 to −0.018) and fifth half-year (−0.106; 95% CI, −0.184 to −0.028) after OORP implementation.
- The implementation of OORP was positively associated with 60-day MOUD initiation in 17 hospitals, with increases in probability ranging from 0.017 to 0.130.
IN PRACTICE:
“Given the variation in implementation models for ED-based PRSSs [peer recovery support services], there is a need for further research, aided by development of a fidelity measure, to identify key intervention components of ED-based PRSSs and the factors influencing effectiveness,” the authors added.
SOURCE:
This study was led by Peter Treitler, PhD, Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, New Jersey, and published online on March 25, 2024, in JAMA Network Open.
LIMITATIONS:
Patients who received the OORP intervention could not be identified due to deidentified data and non-Medicaid reimbursement. The study included patients who were not offered the program and those who declined services, potentially leading to conservative effect estimates. Further, the specific level of service provided to patients varied and was not documented. Using only Medicaid data limited the assessment of outcomes, excluding non-Medicaid treatments, unreported overdoses, and mortality data.
DISCLOSURE:
This study was supported by Arnold Ventures, as well as grants from the National Institute of Health (NIH) through the NIH HEAL Initiative, the National Institute on Drug Abuse ( NIDA), and the National Center for Advancing Translational Sciences. Treitler reported receiving grants from NIDA during the conduct of the study, while Cooperman received grants from the NIH outside the submitted work. No other authors declared conflicts of interest.
Source link : https://www.medscape.com/viewarticle/ed-based-peer-support-program-cuts-opioid-overdose-risks-2024a1000748?src=rss
Author :
Publish date : 2024-04-15 09:51:33
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