Evidence map›Paper›PMID 29799649›Full record

ArticleAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine2018

Implementation of an Opioid Detoxification Management Pathway Reduces Emergency Department Length of Stay.

Shawna D Bellew, Sean P Collins, Tyler W Barrett, Stephan E Russ, Ian D Jones, Corey M Slovis, Wesley H Self

Open access · bronzeAbstract read
In one paragraph

Article in Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
0.7field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Methodological Approaches to Support Process Improvement in Emergency Departments: A Systematic Review.International journal of environmental research and public health · 2020
    Pooled it
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Shawna D BellewVanderbilt University Medical Center, Nashville, TN.
Sean P CollinsVanderbilt University Medical Center, Nashville, TN.
Tyler W BarrettVanderbilt University Medical Center, Nashville, TN.
Stephan E RussVanderbilt University Medical Center, Nashville, TN.
Ian D JonesVanderbilt University Medical Center, Nashville, TN.
Corey M SlovisVanderbilt University Medical Center, Nashville, TN.
Wesley H SelfVanderbilt University Medical Center, Nashville, TN.
Vanderbilt University Medical Center · US

Funding

Salivary Cortisol as a Marker of Community-Acquired Pneumonia Severity in AdultsK23GM110469 · NIGMS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI SELF, WESLEY H · 2015 to 2018
$683k
Intramural VA VA999999NIGMS NIH HHS K23 GM110469
6 · The paper itself

Abstract

objectivesWith the rise of opioid use in the United States, the increasing demand for treatment for opioid use disorders presents both a challenge and an opportunity to develop new care pathways for emergency department (ED) patients seeking opioid detoxification. We set out to improve the care of patients presenting to our ED seeking opioid detoxification by implementing a standardized management pathway and to measure the effects of this intervention.

methodsWe conducted a before-after study of the effects of an opioid detoxification management pathway on ED length of stay (EDLOS), use of resources (social worker consultation, laboratory tests obtained), and return visits to the same ED within 30 days of discharge. All data were collected retrospectively by review of the electronic health record.

resultsUltimately, 107 patients presented to the ED that met criteria, 52 in the intervention period and 55 in the preintervention period. Median EDLOS in the intervention period was 152 (interquartile range [IQR] = 93-237) minutes compared to 312 (IQR = 187-468) minutes in the preintervention period (p < 0.001). Patients in the intervention period less frequently had a social work consultation (32.7% vs. 83.6%, p < 0.001) or had laboratory tests obtained (32.7% vs 74.5%, p < 0.001) and more frequently were prescribed a medication for withdrawal symptoms (57.7% vs. 29.1%, p = 0.003).

conclusionsImplementation of an opioid detoxification management pathway reduced EDLOS, reduced utilization of resources, and increased the proportion of patients prescribed medications for symptom relief.

Indexed as

AdultCritical PathwaysEmergency Service, HospitalFemaleHumansLength of StayMaleMiddle AgedOpioid-Related DisordersRetrospective StudiesUnited States

Identifiers

PMID29799649
PMCPMC6185770
OpenAlexW2803206207

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.