St. Paul's Hospital
Andrew Kestler, MD, MBA, MScPH, DTMH
Clinical Associate Professor, Department of Emergency Medicine, UBC
Physician Lead, Emergency Department Opioid Crisis Response, St. Paul’s Hospital
Emergency Physician, St. Paul’s, Vancouver General, and BC Children’s Hospitals
Emergency Department Opioid Agonist Therapy (EDOAT) Implementation
UBC Emergency Medicine: Jessica Moe, Roy Purssell, Frank Scheuermeyer
CRISM: Kathryn Dong (U. of Alberta), Janusz Kaczorowski (U. of Montreal), Aaron Orkin (U. of Toronto)
BCCSU: Keith Ahamad, Seonaid Nolan, Evan Wood
BCCDC: Jane Buxton
PHC/VCH/PHS: Misty Bath, Emma Garrod, Reka Gustafson, Christy Sutherland
People with opioid use disorder (OUD) visit emergency departments (EDs) often and have high mortality following ED visits. Treating OUD with opioid agonist therapy (OAT) reduces overdose-related and all-cause mortality. ED-initiated OAT (EDOAT) demonstrates better 1-month retention in addiction care than clinic referral alone, but implementation is limited and longer-term outcomes unknown. We aim to evaluate EDOAT in terms of its acceptability to ED physicians and patients, and its impact on OUD mortality, OAT retention, healthcare utilization. We are now analyzing data from national survey of ED physician attitudes and practices on EDOAT. Through questionnaires and qualitative interviews we are soliciting the patient perspective on ED OAT. In the ED, we are screening for OUD patients not yet on OAT to offer them buprenorphine/naloxone to-go and intensive 1-year overdose outreach team follow-up. At the follow-up period’s conclusion, we will review participants’ clinical data for outcomes of interest.
Work in Progress (WiP) presentations take place at St. Paul’s Hospital on alternating Wednesdays from 12:00–1:00 PM. These seminars provide investigators with an opportunity to present ongoing research, obtain feedback from colleagues and peers, and make new connections for their projects. Talks are open, and a light lunch is served.
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