Implementation of Clinical Algorithms for Take-Home Naloxone and Buprenorphine/Naloxone in Emergency Rooms

Status: Completed

CONTEXT

A multidisciplinary group of clinical leaders from the Centre Hospitalier de l’Université de Montréal (CHUM), Notre-Dame Hospital of the CIUSSS Centre-Sud-de-l’Île-de-Montréal and the Hotel-Dieu Hospital of the CIUSSS de l’Estrie CHUS, have implemented this pilot project in Quebec as part of the pressing need for research initiatives to address the opioid crisis. SuboxED is an implementation study that aims to dispense take-home naloxone (THN) and to prescribe buprenorphine/naloxone (B/n) for patients with opioid use disorder (OUD).

SuboxEd has been of critical importance in delivering intranasal naloxone to emergency patients who are at risk of an opioid overdose, free of charge.

Objectives

  • Evaluate the uptake and utilization of the distribution algorithm
  • Assess the experience of health professionals and patients post- implementation.

Result

  • A clinical algorithm can be implanted within 6 months to help reduce overdoses and provide opioid agonist therapy (OAT) to people at risk of overdose.
  • 36% (877) of the patients in the 3 emergency departments were identified as being at risk of overdose, most of whom consulted the emergency room for a pain problem.
  • 7% received a naloxone kit and 12% received a prescription for OAT.
  • 100% of the participating addiction clinics mentioned that this project met the health needs of their patients.
  • 100% of participating pharmacists mentioned that this treatment algorithm should be implemented in all emergency rooms in Quebec.

Funding

This study was funded by Health Canada and the Ministère de la Santé et des Services sociaux (MSSS)/Institut universitaire sur les dépendances (IUD) through the Substance Use and Addiction Program (SUAP): Projet 20 PUDS.

The views expressed in the publication do not necessarily represent those of Health Canada, the Québec Health Minister and the MSSS.

Principal Investigator

Research Team

  • Rania Khemiri: Research Coordinator  (CRCHUM)
  • Aïssata Sako: Program Director  (CRCHUM)

Collaborators

  • Luc Londei-Leduc, MD1
  • Christine Robin, MD2
  • Suzanne Marcotte, Pharmacist1
  • Guenièvre Therrien, MD3
  • Geneviève Goulet, MD2
  • Geneviève Beaudet-Hillman, Nurse1
  • Christine Ouellette, MD4
  • Suzanne Brissette, MD5
  • Marcel Martin, MD3
  • Polina Titova, Research Coordinator5
  • Pierre Lauzon, MD3

Affiliation

  1. Centre hospitalier de l’Université de Montréal, (CHUM)
  2. Hôpital Hôtel-Dieu, CIUSSS de l’Estrie – CHUS
  3. Hôpital Notre-Dame du  CIUSSS Centre-Sud-de-l’Île-de-Montréal
  4.  CIUSSS de l’Est-de-l’Île-de-Montréal
  5. Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM)

For more information

For more information about the study, please contact Rania Khemiri at rania.khemiri.chum@ssss.gouv.qc.ca.

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