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Disparities in Emergency Department Naloxone and Buprenorphine Initiation

INTRODUCTION: Prescribing of buprenorphine and naloxone in the emergency department (ED) has been shown to be an effective intervention. The purpose of this study was to determine the frequency of prescribing of naloxone and buprenorphine and the sub-groups that may be more or less likely to receive...

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Detalles Bibliográficos
Autores principales: Papp, Joan, Emerman, Charles
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Department of Emergency Medicine, University of California, Irvine School of Medicine 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10393464/
https://www.ncbi.nlm.nih.gov/pubmed/37527392
http://dx.doi.org/10.5811/westjem.58636
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author Papp, Joan
Emerman, Charles
author_facet Papp, Joan
Emerman, Charles
author_sort Papp, Joan
collection PubMed
description INTRODUCTION: Prescribing of buprenorphine and naloxone in the emergency department (ED) has been shown to be an effective intervention. The purpose of this study was to determine the frequency of prescribing of naloxone and buprenorphine and the sub-groups that may be more or less likely to receive treatment. METHODS: We used a national electronic health record database to identify patients with opioid poisoning or overdose presenting between January 2019–December 2021. Patients who were prescribed naloxone or buprenorphine were identified in this dataset and then further segmented based on self-identified gender, age, racial and ethnic identity, income categories, and social vulnerability index in order to identify sub-groups that may be less likely to be prescribed treatment. RESULTS: We found 74,004 patients in the database whom we identified as presenting to the ED with an opioid poisoning or overdose. Overall, 22.8% were discharged with a prescription for naloxone, while 0.9% of patients were discharged with buprenorphine products. Patients were less likely to receive naloxone prescriptions if they were female, White or Pacific Islander, non-Hispanic, not between the ages of 18–65, and non-English speaking. We found the same pattern for buprenorphine prescriptions except that the results were not significant for ethnicity and English-speaking. CONCLUSION: Despite evidence supporting its use, buprenorphine is not prescribed from the ED in a substantial proportion of patients. Naloxone is prescribed to a higher percentage, although still a minority of patients receive it. Some sub-groups are disadvantaged in the prescribing of these products. Further study may assist in improving the prescribing of these therapies.
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spelling pubmed-103934642023-08-02 Disparities in Emergency Department Naloxone and Buprenorphine Initiation Papp, Joan Emerman, Charles West J Emerg Med Behavioral Health INTRODUCTION: Prescribing of buprenorphine and naloxone in the emergency department (ED) has been shown to be an effective intervention. The purpose of this study was to determine the frequency of prescribing of naloxone and buprenorphine and the sub-groups that may be more or less likely to receive treatment. METHODS: We used a national electronic health record database to identify patients with opioid poisoning or overdose presenting between January 2019–December 2021. Patients who were prescribed naloxone or buprenorphine were identified in this dataset and then further segmented based on self-identified gender, age, racial and ethnic identity, income categories, and social vulnerability index in order to identify sub-groups that may be less likely to be prescribed treatment. RESULTS: We found 74,004 patients in the database whom we identified as presenting to the ED with an opioid poisoning or overdose. Overall, 22.8% were discharged with a prescription for naloxone, while 0.9% of patients were discharged with buprenorphine products. Patients were less likely to receive naloxone prescriptions if they were female, White or Pacific Islander, non-Hispanic, not between the ages of 18–65, and non-English speaking. We found the same pattern for buprenorphine prescriptions except that the results were not significant for ethnicity and English-speaking. CONCLUSION: Despite evidence supporting its use, buprenorphine is not prescribed from the ED in a substantial proportion of patients. Naloxone is prescribed to a higher percentage, although still a minority of patients receive it. Some sub-groups are disadvantaged in the prescribing of these products. Further study may assist in improving the prescribing of these therapies. Department of Emergency Medicine, University of California, Irvine School of Medicine 2023-07 2023-06-30 /pmc/articles/PMC10393464/ /pubmed/37527392 http://dx.doi.org/10.5811/westjem.58636 Text en © 2023 Papp et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) License. See: http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/)
spellingShingle Behavioral Health
Papp, Joan
Emerman, Charles
Disparities in Emergency Department Naloxone and Buprenorphine Initiation
title Disparities in Emergency Department Naloxone and Buprenorphine Initiation
title_full Disparities in Emergency Department Naloxone and Buprenorphine Initiation
title_fullStr Disparities in Emergency Department Naloxone and Buprenorphine Initiation
title_full_unstemmed Disparities in Emergency Department Naloxone and Buprenorphine Initiation
title_short Disparities in Emergency Department Naloxone and Buprenorphine Initiation
title_sort disparities in emergency department naloxone and buprenorphine initiation
topic Behavioral Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10393464/
https://www.ncbi.nlm.nih.gov/pubmed/37527392
http://dx.doi.org/10.5811/westjem.58636
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