The Impact of a Peer-Navigator Program on Naloxone Distribution and Buprenorphine Utilization in the Emergency Department

Ramdin, Christine; Guo, Marshall; Fabricant, Scott A.; Santos, Cynthia; Nelson, Lewis S.

doi:10.1080/10826084.2021.2023187

Cited by 11 publications

(28 citation statements)

References 25 publications

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“… 24 Four studies assessed the impact of a naloxone program, one of which paired naloxone distribution with peer recovery coaching. 25 , 26 , 27 , 28 Finally, one study focused specifically on racial and ethnic differences among patients provided naloxone at discharge. 29 The methodologies of these studies varied, where one used an interventional approach, 18 seven used a cross‐sectional approach, 19 , 20 , 22 , 24 , 25 , 26 , 29 three used a longitudinal cohort approach, 21 , 23 , 28 and one study was a retrospective time period analysis.…”

Section: Resultsmentioning

confidence: 99%

Naloxone distribution programs in the emergency department: A scoping review of the literature

Sindhwani,

Friedman,

O'Donnell

et al. 2024

JACEP Open

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This scoping review summarized the literature regarding naloxone distribution from emergency departments (EDs) without a prescription. Our intention was to examine various naloxone distribution programs, their methodologies, and the level of effectiveness of each. Understanding these key aspects of naloxone distribution could lead to improved standardized protocols, saving countless additional lives from opioid overdose. This review evaluated studies reporting naloxone distribution from EDs in the United States. The included studies were written in English and published between January 1, 2017, and December 31, 2022. Searches were performed using PubMed and Embase. A total of 129 studies were reviewed, with only 12 meeting the necessary criteria for analysis. Heterogeneity was found across naloxone distribution programs, including how patients were identified, how naloxone was dispensed to patients, and the specific naloxone products made available. The protocols included various methods, such as patient screening, where information used for this screening was sometimes obtained from health records or patient interviews. Some programs detailed only the distribution of naloxone, while others included additional interventions such as behavior counseling, peer support, and education. In four studies, patients received buprenorphine with naloxone kits. The various programs differed in their implementation but were generally successful in improving naloxone distribution. However, among the studies reviewed, the percentage of ED patients receiving naloxone varied from ∼30% to 70%, suggesting that certain program elements may be more impactful. Further research is needed to identify key elements of the most impactful programs in order to improve naloxone distribution and improve patient odds of surviving an opioid overdose.

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Section: Resultsmentioning

confidence: 99%

Naloxone distribution programs in the emergency department: A scoping review of the literature

Sindhwani,

Friedman,

O'Donnell

et al. 2024

JACEP Open

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“…Although previous studies have indicated value in peer services, [6][7][8][9][10][11][12][13][14][15][16][17][18] including positioning peers in the linkage facilitator or treatment navigation role, [19][20][21] little research has focused on peer navigation specific to SUD treatment for recently incarcerated women. Findings highlight the breadth of needs reported by women in the present sample prior to release, including transportation, employment, housing, mental or physical health, and complex interpersonal relationships, all of which have been highlighted in previous research on women's reentry 16 and may pose as major barriers to engagement with OUD treatment and sustaining recovery.…”

Section: Discussionmentioning

confidence: 99%

“…Peer navigators can be seen as an extension of a clinical care team, much like community health workers, and can play key roles in engaging individuals in research and linkage to care. [19][20][21] Thus, peer navigation has potential to improve the health and well-being of women with OUD post-incarceration through sharing of professional and experiential knowledge related to systems of care for OUD and related health issues.…”

mentioning

confidence: 99%

Providing peer navigation services to women with a history of opioid misuse pre- and post-release from jail: A program description

Tillson¹,

Fallin‐Bennett²,

Staton³

2022

J. Clin. Trans. Sci.

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“…These outcomes are often credited to the emotional, instrumental, and informational support provided by PRCs that are beyond the scope of substance use disorder professionals who are strictly clinically focused [17,18]. There is additional evidence supporting the ability of PRCs who work in EDs to identify patients who use opioids, provide them with harm reduction and supportive services, and link them with appropriate opioid use disorder treatment [6,9,[19][20][21]. PRCs can also help bridge a documented gap in the willingness of ED physicians to provide harm reduction interventions or treat opioid use disorder [22,23].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of post-discharge engagement for emergency department patients with opioid use history who received telehealth recovery coaching services

Watson

Phalen

Medcalf

et al. 2023

Subst Abuse Treat Prev Policy

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Background In recent years, emergency departments (EDs) across the nation have implemented peer recovery coach (PRC) services to support patients who use opioids. The majority of such interventions discussed in the literature follow an in-person modality where PRCs engage patients directly at the ED bedside. However, the use of telehealth services in EDs is becoming more popular. These services connect PRCs with ED patients in real-time via secure communications technology, and very little is known about the service- and clinical-based outcomes with which they are associated. The current study sought to assess factors associated with successful post-discharge follow-up of patients with a history of opioid use who received PRC telehealth services while in the ED. Method Data come from records for 917 patients who engaged with a telehealth PRC one or more times (1208 total engagements) at 1 of 13 EDs within the same health system. A multilevel Poisson regression model was used to assess the degree to which variables predicted successful post-discharge follow-up, defined as the number of times a PRC successfully spoke with the patient each month after ED discharge. Results At least one follow-up was successfully completed by a PRC for 23% of enrolled patients. Significant predictors of successful follow-up included patient employment at baseline (Incidence Rate Ratio [IRR]: 2.8, CI: 2.05–3.9), living in a rural area (IRR: 1.8, CI: 1.04–3.2), PRC provision of referrals (IRR: 1.7, CI: 1.2–2.2), number of ED encounters in the previous 365 days (IRR: 0.99, CI: 0.98–0.99), and duration of the initial PRC telehealth interaction (IRR: 0.87, CI: 0.85–0.88). Conclusion Given that relationship development is a key tool in the PRC profession, understanding successful follow-up associated with telehealth engagement has unique importance. The results have potential utility for planning and implementing peer telehealth services in EDs and other locations, which is needed for the development of the PRC profession and the likely expansion of peer telehealth services.

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The Impact of a Peer-Navigator Program on Naloxone Distribution and Buprenorphine Utilization in the Emergency Department

Cited by 11 publications

References 25 publications

Naloxone distribution programs in the emergency department: A scoping review of the literature

Naloxone distribution programs in the emergency department: A scoping review of the literature

Providing peer navigation services to women with a history of opioid misuse pre- and post-release from jail: A program description

Evaluation of post-discharge engagement for emergency department patients with opioid use history who received telehealth recovery coaching services

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