141 Rates of filled buprenorphine prescriptions after initiation in the emergency department
Recommended Citation
Mohammed A, Patel M, Loszewski C, Tuttle JE, Chien C, Condon S, Rammal J, Almri Y, Miller J, Manteuffel J. 141 Rates of filled buprenorphine prescriptions after initiation in the emergency department. Acad Emerg Med 2024; 31(S1):73.
Document Type
Conference Proceeding
Publication Date
5-13-2024
Publication Title
Acad Emerg Med
Abstract
Background and Objectives: Opioid use is prevalent in the United States and with the emergence of fentanyl, overdose-related deaths are rising exponentially. The emergency department (ED) is often the only source of care for patients with opioid use disorder (OUD) and there is opportunity to initiate medications for opioid use disorder (MOUD). However, there is insufficient data regarding efficacy of initiation of MOUD due to limited to follow up. Our objective was to evaluate the rate of filled buprenorphine prescriptions after initiation of MOUD in the ED. We hypothesized that ED-initiated buprenorphine would continue at high rates in the months after the initial intervention. Methods: We performed a retrospective analysis of 47 patients who presented to the ED from June to December 2021. Patients were included if they were in opioid withdrawal, had not been prescribed MOUD in the 14?days prior to ED presentation, and were provided with buprenorphine and referral to treatment. We utilized PMPAWARXE-MAPS to determine whether patients had filled at least one prescription for buprenorphine at 3 intervals: 3?months to 2?weeks prior to ED induction, 0–6 and 6–12?months after ED induction. Analysis included chi-square or Fisher exact testing with reported odds ratios (OR) and 95% confidence intervals (CI). Results: In the 3?months to 2?weeks prior to ED induction, 11/47 (23.4%) patients had filled a prescription for buprenorphine. In 0–6?months post-induction, a prescription was filled by 26/47 (55.3%) patients, and by 13/47 (26.7%) patients at 6–12?months post-induction. There were 33 (70.2%) patients referred to outpatient addiction treatment (OAT) and 14 (29.2%) patients referred to inpatient addiction treatment (IAT). Patients referred to OAT had higher rates of filled prescriptions than IAT patients at both 0–6?months (57.6% vs. 50%, OR 1.36, 95% CI 0.39–4.76) and 6–12?months (33% vs. 7.1%, OR 6.50, 95% CI 0.75–56.30). Conclusion: In this small study, we demonstrate an increase in rates of filled buprenorphine prescriptions after induction in the ED. This effect is higher in the initial period after induction and in those referred to OAT. Patients may still be engaged in addiction treatment despite not filling buprenorphine prescriptions, particularly if they are prescribed long-acting injectable buprenorphine or non-opioid medications. Data regarding MOUD use after ED initiation is scarce and further study is needed.
Volume
31
Issue
S1
First Page
73
