Patients First Prescribed MAT for OUD in Emergency Settings Failing to Continue Treatment

More than two-thirds of patients who receive medication to treat opioid use disorder in emergency departments do not sustain their treatment, according to a new study from the RAND Corporation. The findings indicate that new approaches may be needed to help people stay in OUD treatment if the treatment was started in an emergency setting.

Findings from the study, which was the first national assessment of the frequency with which buprenorphine prescriptions written by emergency physicians for patients not currently taking the medication, were published in the Annals of Emergency Medicine.

To conduct the study, the RAND researchers looked at records that cover 92% of prescriptions filled at US retail pharmacies, and identified buprenorphine prescriptions written by emergency physicians and filled between Feb. 1, 2019, and Nov. 30, 2020. The researchers calculated the rate at which patients filled buprenorphine prescriptions from nonemergency clinicians, the frequency with which subsequently filled prescriptions came from different types of prescribers, and changes in subsequent prescription rates after the declaration of the COVID-19 emergency.

RAND found that during the period studied, 71.5% of patients who initially filled buprenorphine prescriptions that were written by emergency physicians did not fill subsequent prescriptions from other clinicians. The percentage increased after the onset of the pandemic.

“It’s positive that more people are being given medication for their opioid use disorder when they seek help in an emergency department,” said Bradley D. Stein, MD, PhD, the study’s lead author and a senior physician researcher at RAND. “But there is substantial room for improvement to create a system of care that seamlessly transitions patients from the emergency setting to community treatment providers who can continue treatment.”

References

Most people who receive medication in emergency departments to treat opioid use disorder do not sustain the treatment, study finds. News release. RAND Corporation. March 21, 2022. Accessed March 21, 2022.

Stein BD, Saloner B, Kerber R, Sorbero M, Gordon AJ. Subsequent buprenorphine treatment following emergency physician buprenorphine prescription fills: A national assessment 2019 to 2020. Annals of Emergency Medicine. 2022. doi:10.1016/j.annemergmed.2022.01.042