• Ann Emerg Med · Mar 2023

    Effectiveness of Substance Use Navigation for Emergency Department Patients with Substance Use Disorders: An Implementation Study.

    • Erik S Anderson, Evan Rusoja, Joshua Luftig, Monish Ullal, Ranjana Shardha, Henry Schwimmer, Alexandra Friedman, Christian Hailozian, and Andrew A Herring.
    • Department of Emergency Medicine, Highland Hospital - Alameda Health System, Oakland, CA; Substance Use Disorder Program, Highland Hospital - Alameda Health System, Oakland, CA. Electronic address: esanderson@alamedahealthsystem.org.
    • Ann Emerg Med. 2023 Mar 1; 81 (3): 297308297-308.

    Study ObjectiveWe implemented a whole person care-informed intervention delivered by substance use navigators (SUN) for emergency department (ED) patients with substance use disorders.MethodsThis was an implementation study of adult patients discharged from 3 public hospital EDs between September 1, 2021 through January 31, 2022 with cocaine, methamphetamine, alcohol, and opioid use-related diagnoses. The primary effectiveness outcome was treatment engagement within 30 days of ED discharge among patients with and without the SUN intervention. We used logistic regression and nearest neighbor propensity score matching without replacement to control for confounding effects.ResultsThere were 1,328 patients in the cohort, and 119 (9.0%) received the SUN intervention; 50.4% of patients in the SUN intervention group and 15.9% of patients without the SUN intervention were engaged in outpatient treatment within 30 days of ED discharge (difference in proportions: 34.5%, 95% confidence interval [CI] 25.3% to 43.8%). In the unadjusted analysis, the SUN intervention was associated with higher rates of treatment engagement after ED discharge for patients with alcohol, opioid, and cocaine-related diagnoses; patients with methamphetamine-related diagnoses had low engagement rates with or without the SUN intervention. In addition, the SUN intervention was associated with higher odds of treatment engagement in the multivariable model (aOR 3.7, 95% CI 2.4 to 5.8) and in the propensity score-matched analysis (OR 2.1, 95% CI 1.2 to 3.5).ConclusionA whole person care-informed intervention delivered by SUNs for ED patients with substance use disorders was strongly associated with higher engagement rates in addiction treatment after discharge.Copyright © 2022 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

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