FACTORS ASSOCIATED WITH TREATMENT ENGAGEMENT AMONG EMERGENCY DEPARTMENT PATIENTS WITH OPIOID USE DISORDER AFTER DISCHARGE: A RETROSPECTIVE COHORT STUDY
Author(s)
Janvi Morker, PharmD Candidate1, Shruti Patel, PharmD Candidate1, Kaithlyn Pham, PharmD Candidate1, Dennis Hand, PhD2, Ruth Jeminiwa, PhD3;
1Thomas Jefferson University- Jefferson College of Pharmacy, Philadelphia, PA, USA, 2Thomas Jefferson University- Jefferson College of Nursing, Philadelphia, PA, USA, 3Thomas Jefferson University-Jefferson College of Pharmacy, Philadelphia, PA, USA
1Thomas Jefferson University- Jefferson College of Pharmacy, Philadelphia, PA, USA, 2Thomas Jefferson University- Jefferson College of Nursing, Philadelphia, PA, USA, 3Thomas Jefferson University-Jefferson College of Pharmacy, Philadelphia, PA, USA
OBJECTIVES: Emergency departments (EDs) are critical points of contact between those with opioid use disorder (OUD) and the healthcare system. Successful care connection after ED encounters may help reduce preventable deaths such as fatal opioid overdose. However, post-discharge treatment engagement remains suboptimal. Understanding factors associated with engagement can inform targeted interventions. This study aimed to assess the proportion of ED patients with OUD who engaged in OUD treatment within three months after visiting an ED and identify factors associated with treatment engagement.
METHODS: We conducted a retrospective cohort study of adults (≥18 years) presenting to the ED with an OUD diagnosis between April 2020 and December 2024 using electronic health record data of a large healthcare system. Post-discharge treatment engagement(Yes/No) was defined as any follow-up visit within three months of the ED encounter with an addiction specialist, behavioral health provider or primary care provider that involved prescribing or managing medications for OUD. Variables included demographics, housing stability, overdose history, and comorbidities index (12 chronic conditions were coded as binary indicators, and a comorbidity index was calculated as the sum of conditions present). Binary logistic regression identified factors associated with treatment engagement.
RESULTS: Among 929 patients, only 30% engaged in OUD treatment within three months of an ED visit. Factors associated with post-discharge treatment engagement included sex, housing status, comorbidity index, age, and overdose history. Patients experiencing housing instability, those with prior overdose, more comorbid conditions, and female sex were more likely to engage in post-discharge OUD treatment after visiting the ED. Older patients were less likely to engage in OUD treatment after discharge from the ED.
CONCLUSIONS: Despite ED encounters offering opportunities for intervention, most patients did not engage in OUD treatment post-discharge. Targeted strategies addressing identified factors are needed to improve linkage to care and continuity of treatment.
METHODS: We conducted a retrospective cohort study of adults (≥18 years) presenting to the ED with an OUD diagnosis between April 2020 and December 2024 using electronic health record data of a large healthcare system. Post-discharge treatment engagement(Yes/No) was defined as any follow-up visit within three months of the ED encounter with an addiction specialist, behavioral health provider or primary care provider that involved prescribing or managing medications for OUD. Variables included demographics, housing stability, overdose history, and comorbidities index (12 chronic conditions were coded as binary indicators, and a comorbidity index was calculated as the sum of conditions present). Binary logistic regression identified factors associated with treatment engagement.
RESULTS: Among 929 patients, only 30% engaged in OUD treatment within three months of an ED visit. Factors associated with post-discharge treatment engagement included sex, housing status, comorbidity index, age, and overdose history. Patients experiencing housing instability, those with prior overdose, more comorbid conditions, and female sex were more likely to engage in post-discharge OUD treatment after visiting the ED. Older patients were less likely to engage in OUD treatment after discharge from the ED.
CONCLUSIONS: Despite ED encounters offering opportunities for intervention, most patients did not engage in OUD treatment post-discharge. Targeted strategies addressing identified factors are needed to improve linkage to care and continuity of treatment.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
RWD47
Topic
Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems