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. 2022 Jul 11;23(4):461-467.
doi: 10.5811/westjem.2022.2.52978.

Improving Uptake of Emergency Department-initiated Buprenorphine: Barriers and Solutions

Timothy D Kelly  1 , Kathryn F Hawk  2 , Elizabeth A Samuels  3 , Reuben J Strayer  4 , Jason A Hoppe  5
Affiliations

Improving Uptake of Emergency Department-initiated Buprenorphine: Barriers and Solutions

Timothy D Kelly et al. West J Emerg Med. .

Abstract

Emergency departments (ED) are increasingly providing buprenorphine to persons with opioid use disorder. Buprenorphine programs in the ED have strong support from public health leaders and emergency medicine specialty societies and have proven to be clinically effective, cost effective, and feasible. Even so, few ED buprenorphine programs currently exist. Given this imbalance between evidence-based practice and current practice, proven behavior change approaches can be used to guide local efforts to expand ED buprenorphine capacity. In this paper, we use the theory of planned behavior to identify and address the 1) clinician factors, 2) institutional factors, and 3) external factors surrounding ED buprenorphine implementation. By doing so, we seek to provide actionable and pragmatic recommendations to increase ED buprenorphine availability across different practice settings.

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Conflict of interest statement

Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. No author has professional or financial relationships with any companies that are relevant to this study. There are no conflicts of interest or sources of funding to declare.

Figures

Figure 1
Figure 1
Conceptual diagram. ED, emergency department; EM, emergency medicine; OUD, opioid use disorder.
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