Evidence map›Paper›PMID 34548331›Full record

ArticleCMAJ open

A cross-sectional survey on buprenorphine-naloxone practice and attitudes in 22 Canadian emergency physician groups: a cross-sectional survey.

Andrew Kestler, Janusz Kaczorowski, Kathryn Dong, Aaron M Orkin, Raoul Daoust, Jessica Moe, Kelsey Van Pelt, Gary Andolfatto, Michelle Klaiman, Justin Yan and 10 more

Erratum issuedOpen access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
2.4field-weighted citation impact, top 12% 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

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.

  1. Pooled it
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

20 authors at 2 institutions in 1 country.

Andrew KestlerDepartment of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que. Andrew.kestler@ubc.ca.
Janusz KaczorowskiDepartment of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que.
Kathryn DongDepartment of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que.
Aaron M OrkinDepartment of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que.
Raoul DaoustDepartment of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que.
Jessica MoeDepartment of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que.
Kelsey Van PeltDepartment of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que.
Gary AndolfattoDepartment of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que.
Michelle KlaimanDepartment of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que.
Justin YanDepartment of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que.
Justin J KohDepartment of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que.
Kathryn CrowderDepartment of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que.
Devon WebsterDepartment of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que.
Paul AtkinsonDepartment of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que.
David SavageDepartment of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que.
James StempienDepartment of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que.
Floyd BessererDepartment of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que.
Jason WaleDepartment of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que.
Alice LamDepartment of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que.
Frank ScheueremeyerDepartment of Emergency Medicine (Kestler, Moe, Scheueremeyer), University of British Columbia, Vancouver, BC; Département de médecine de famille et de médecine d'urgence ( Kaczorowski), Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Dong), University of Alberta, Edmonton, Alta.; Department of Family & Community Medicine (Orkin), University of Toronto, Toronto, Ont.; Centre de recherche de l'Hôpital Sacré-Coeur de Montréal (Daoust), Montréal, Que.; British Columbia Centre on Substance Use (Van Pelt), Vancouver, BC; Department of Emergency Medicine (Andolfatto), University of British Columbia, North Vancouver, BC; Department of Medicine (Klaiman), University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Yan), Schulich School of Medicine & Dentistry, Western University, London, Ont.; Department of Emergency Medicine (Koh, Stempien), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Crowder), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Webster, Atkinson), Dalhousie University, St. John, NB; Division of Clinical Sciences (Savage), Northern Ontario School of Medicine, Thunder Bay, Ont.; Department of Emergency Medicine (Besserer), University of British Columbia, Prince George, BC; Department of Emergency Medicine (Wale), University of British Columbia, Victoria, BC; Centre de recherche du Centre hospitalier de l'Université de Montréal (Lam), Montréal, Que.; Canadian Research Initiative in Substance Misuse (Lam), Montréal, Que.
Hôpital du Sacré-Cœur de Montréal · CAWestern University · CA

Funding

CIHR
6 · The paper itself

Abstract

backgroundBuprenorphine-naloxone (BUP) initiation in emergency departments improves follow-up and survival among patients with opioid use disorder. We aimed to assess self-reported BUP-related practices and attitudes among emergency physicians.

methodsWe designed a cross-sectional physician survey by adapting a validated questionnaire on opioid harm reduction practices, attitudes and barriers. We recruited physician leads from 6 Canadian provinces to administer surveys to the staff physicians in their emergency department groups between December 2018 and November 2019. We included academic and community non-locum emergency department staff physicians. We excluded responses from emergency department groups with response rates less than 50% to minimize nonresponse bias. Primary (BUP prescribing practices) and secondary (willingness and attitudes) outcomes were analyzed using descriptive statistics.

resultsAfter excluding 1 group for low response (9/26 physicians), 652 of 798 (81.7%) physicians responded from 22 groups serving 34 emergency departments. Among respondents, 64.1% (95% confidence interval [CI] 60.4%-67.8%, emergency department group range 7.1%-100.0%) had prescribed BUP at least once in their career, 38.4% had prescribed it for home initiation and 24.8% prescribed it at least once a month. Overall, 68.9% (95% CI 65.3%-72.4%, emergency department group range 24.1%-97.6%) were willing to administer BUP, 64.2% felt it was a major responsibility and 37.1% felt they understood people who use drugs. Respondents most frequently rated lack of adequate training (58.2%) and lack of time (55.2%) as very important barriers to BUP initiation.

interpretationTwo-thirds of the emergency physicians surveyed prescribed BUP, although only one-quarter did so regularly and one-third prescribed it for home initiation; wide variation between emergency department groups existed. Strategies to increase BUP initiation must address physicians' lack of time and training for BUP initiation and improve their understanding of people who use drugs.

Indexed as

Attitude of Health PersonnelOpioid-Related DisordersPhysiciansBuprenorphine, Naloxone Drug CombinationCanadaCross-Sectional StudiesEmergency Service, HospitalFemaleHealth Care SurveysHumansMaleMiddle AgedNarcotic AntagonistsNeeds AssessmentPractice Patterns, Physicians'Staff DevelopmentBuprenorphine, Naloxone Drug CombinationNarcotic Antagonists

Identifiers

PMID34548331
PMCPMC8476213
OpenAlexW3199923238

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LicenceCC BY-NC-ND
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Registered trials

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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.