In 2018, California established a program called CA Bridge to expand medication for addiction treatment in emergency departments. The state-funded program has been adopted by nearly 300 California hospitals. Now, a new project at UC Davis seeks to improve the impact of CA Bridge by developing and testing strategies to boost long-term buprenorphine adherence for patients after they leave the ED.
The National Institute on Drug Abuse has awarded UC Davis a grant to develop and test a team-based strategy to improve treatment for patients with opioid use disorder (OUD). The $1 million grant funded by the National Institutes of Health (NIH) will help design an intervention that supports low-income and other vulnerable patients who seek OUD care in EDs.
The overall objective is to develop a blueprint that hospitals in California and across the U.S. can use to improve OUD treatment for patients who start buprenorphine in EDs.
“We are thrilled to work on a multi-team strategy to improve buprenorphine adherence for patients who start their OUD treatment in the emergency department. It is important to coordinate their care and reduce their risk of opioid overdose,” said primary care physician Stephen Henry, M.D., in a statement. Henry is an associate professor of internal medicine, faculty member affiliated with the Center for Healthcare Policy and Research, and co-principal investigator on the project.
CA Bridge offers patients with OUD who seek care in an ED buprenorphine the same day, evaluation by a drug and alcohol counselor, and referral to primary care. This combined treatment plan has significantly increased buprenorphine treatment rates.
The UC Davis researchers will test an approach that encourages better coordination between ED and primary care teams. Their strategy involves ongoing partnerships rather than one-time hand-offs. They will assess if these partnerships improve buprenorphine treatment and patient retention rates.
“For patients with opioid use disorder, starting and maintaining treatment is a life-saving intervention,” said Aimee Moulin, M.D., professor of emergency medicine and co-PI on this award, in a statement. “Effective transitions of care between the ED and primary care are critical for reducing overdose deaths and helping patients move towards recovery.”
The team will collect and analyze data from two CA Bridge sites to identify factors linked to the successful implementation and sustainability of treatment.
This grant will set the stage for a subsequent $4.8 million grant after the team meets certain milestones.
“This initial grant will focus on intervention development,” said co-PI Shin-Ping Tu, M.D., M.P.H., in a statement. She is a professor in the Department of Internal Medicine and a co-director of the Clinical and Translational Science Center’s Healthcare Delivery Science program. “The next grant will test our implementation strategy’s impact on the rates of buprenorphine initiation and sustained treatment 3, 6 and 12 months after patients leave the ED.”
The team will conduct interviews with patients, staff and managers at each emergency department and primary care clinic before and after the project is put into place.