Academic Journal
Patient Perspectives on Offers of Buprenorphine in the Emergency Department.
| Τίτλος: | Patient Perspectives on Offers of Buprenorphine in the Emergency Department. |
|---|---|
| Συγγραφείς: | Jennings LK; Department of Emergency Medicine, Medical University of South Carolina, Charleston., Barth K; Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston., Lane S; Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston., Rafferty A; Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston., Papa C; Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston., Haynes L; Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston., Sonne S; Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston., McCowin H; Mercy Health, Youngstown, Ohio., Moschella P; Department of Medicine and Emergency Medicine, Prisma Health, University of South Carolina School of Medicine Greenville, Greenville., Litwin AH; Department of Medicine and Emergency Medicine, Prisma Health, University of South Carolina School of Medicine Greenville, Greenville., Manteuffel JJ; Department of Emergency Medicine, Henry Ford Health System, Detroit, Michigan., Brady K; Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston., Moreland A; Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston. |
| Πηγή: | JAMA network open [JAMA Netw Open] 2026 Oct 01; Vol. 9 (10), pp. e2637671. Date of Electronic Publication: 2026 Oct 01. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: American Medical Association Country of Publication: United States NLM ID: 101729235 Publication Model: Electronic Cited Medium: Internet ISSN: 2574-3805 (Electronic) Linking ISSN: 25743805 NLM ISO Abbreviation: JAMA Netw Open Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Chicago, IL : American Medical Association, [2018]- |
| Ιατρικοί όροι (MeSH): | Buprenorphine*/therapeutic use , Emergency Service, Hospital*/statistics & numerical data , Opioid-Related Disorders*/drug therapy , Opioid-Related Disorders*/psychology , Opiate Substitution Treatment*/psychology , Opiate Substitution Treatment*/methods , Narcotic Antagonists*/therapeutic use , Patient Acceptance of Health Care*/psychology , Patient Acceptance of Health Care*/statistics & numerical data, Humans ; Male ; Adult ; Female ; Middle Aged ; Qualitative Research ; Ohio ; Michigan |
| Περίληψη: | Importance: Buprenorphine reduces mortality in opioid use disorder (OUD), and emergency department-initiated buprenorphine (EDIB) doubles 30-day treatment retention, yet many patients decline EDIB when offered. Patient-driven factors limiting uptake are not well characterized. Objective: To identify factors associated with patients accepting or declining EDIB. Design, Setting, and Participants: Convergent parallel mixed-methods qualitative study conducted from May 1 to December 31, 2023, with data analyses performed from March 2025 to April 2026, at 4 emergency departments within the National Drug Abuse Treatment Clinical Trials Network (CTN) in South Carolina, Michigan, and Ohio. Adult patients (aged ≥18 years) with OUD who were offered buprenorphine by clinical staff were eligible; prisoners and patients concurrently enrolled in other CTN trials of OUD treatment or overdose prevention were excluded. Main Outcomes and Measures: The main outcomes were acceptance or declination of EDIB; validated measures of treatment readiness (Stages of Change Readiness and Treatment Engagement Scale [SOCRATES]), cultural mistrust, perceived discrimination, and social needs; and qualitative interview themes regarding reasons for accepting or declining buprenorphine. Results: Eighty-two participants completed the study (median [IQR] age, 38 [31-53.5] years; 52 male [64%]). Overall, 19 participants (23%) declined buprenorphine. Among 54 participants who described reasons for accepting EDIB, motivators for accepting EDIB included assistance with opioid withdrawal (37 [69%]), desire to be substance free (21 [39%]), wanting to return to a "normal life" (15 [28%]), fear of overdose or death (13 [24%]), and caring for children (7 [13%]). Among 22 participants who described reasons for declining EDIB, barriers included concern about precipitated withdrawal or adverse effects (11 [50%]), not wanting to be physically dependent on buprenorphine (7 [32%]), and housing and logistical barriers (5 [23%]). SOCRATES treatment readiness (1-5 scale) was similar in patients who accepted (mean [SD] score, 4.11 [0.55]) and declined (mean [SD] score, 4.05 [0.50]) EDIB. Conclusions and Relevance: In this mixed-methods qualitative study of adult ED patients with OUD who were offered buprenorphine, declination was driven less by low treatment readiness than by specific, addressable concerns: precipitated withdrawal, physical dependence, and housing and logistical barriers. Targeted interventions addressing these concerns may increase uptake of this life-saving treatment. |
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| Substance Nomenclature: | 40D3SCR4GZ (Buprenorphine) 0 (Narcotic Antagonists) |
| Entry Date(s): | Date Created: 20261006 Date Completed: 20261006 Latest Revision: 20261009 |
| Update Code: | 20261009 |
| PubMed Central ID: | PMC13643581 |
| DOI: | 10.1001/jamanetworkopen.2026.37671 |
| PMID: | 42837150 |
| Βάση Δεδομένων: | MEDLINE |
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