Evidence map›Paper›PMID 40140748›Full record

ArticleBMC psychiatry2025

Impact of an opioid use disorder medication implementation intervention on hospitalization and emergency department utilization in the Veterans Health Administration.

Madeline C Frost, Carol A Malte, Amy J Kennedy, Andrew J Saxon, Adam J Gordon, Hildi J Hagedorn, Emily C Williams, Ryan S Trim, Aline Lott, Anissa N Danner and 1 more

Abstract read
In one paragraph

Article in BMC psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Observational
  2. 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

11 authors.

Madeline C FrostHealth Systems Research (HSR) Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Care System, 1660 S Columbian Way, Seattle, WA, 98108, USA. mcfrost@uw.edu.
Carol A MalteHealth Systems Research (HSR) Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Care System, 1660 S Columbian Way, Seattle, WA, 98108, USA.
Amy J KennedyCenter of Excellence in Substance Addiction Treatment and Education, VA Puget Sound Health Care System, 1660 S Columbian Way, Seattle, WA, 98108, USA.
Andrew J SaxonCenter of Excellence in Substance Addiction Treatment and Education, VA Puget Sound Health Care System, 1660 S Columbian Way, Seattle, WA, 98108, USA.
Adam J GordonInformatics, Decision-Enhancement, and Analytic Sciences Center, Health Systems Research, VA Salt Lake City Health Care System, 500 Foothill Dr, Salt Lake City, UT, 84148, USA.
Hildi J HagedornCenter of Excellence in Substance Addiction Treatment and Education, VA Puget Sound Health Care System, 1660 S Columbian Way, Seattle, WA, 98108, USA.
Emily C WilliamsHealth Systems Research (HSR) Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Care System, 1660 S Columbian Way, Seattle, WA, 98108, USA.
Ryan S TrimCenter of Excellence in Substance Addiction Treatment and Education, Corporal Michael J. Crescenz Philadelphia VA Medical Center, 3900 Woodland Ave, Philadelphia, PA, 19104, USA.
Aline LottHealth Systems Research (HSR) Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Care System, 1660 S Columbian Way, Seattle, WA, 98108, USA.
Anissa N DannerHealth Systems Research (HSR) Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Care System, 1660 S Columbian Way, Seattle, WA, 98108, USA.
Eric J HawkinsHealth Systems Research (HSR) Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Care System, 1660 S Columbian Way, Seattle, WA, 98108, USA.

Funding

VHA Health Services Research and Development Quality Enhancement Research Initiative Partnered Evaluation Initiatives 18-203 and 19-001
6 · The paper itself

Abstract

backgroundIt is important to evaluate how medication for opioid use disorder (MOUD) implementation interventions impact downstream outcomes, however little is known about impact on hospitalization and emergency department (ED) utilization. Stepped Care for Opioid Use Disorder Train the Trainer (SCOUTT) is a national United States Veterans Health Administration (VHA) effort initially implemented at 18 facilities that increased MOUD receipt in primary care, mental health, and pain clinics. This evaluation assessed SCOUTT's impact on hospitalization and ED utilization.

methodsThis evaluation used a controlled interrupted time series analysis. We extracted electronic health record data for patients with OUD and ≥ 1 visit in an intervention clinic (N = 35) or matched comparison clinic (N = 35) in the post-implementation year. We examined monthly measures of hospitalization and ED utilization in the pre-implementation (9/1/2017-8/31/2018) and post-implementation (9/1/2018-8/31/2019) years. Segmented regression models estimated pre-post immediate and trend changes in intervention relative to comparison clinics, adjusting for pre-implementation trends and patient characteristics. Sensitivity analyses were conducted among patients with ≥ 1 visit in both the pre-/post-implementation years, and post-hoc secondary analyses were conducted among patients with OUD and ≥ 1 other SUD vs. OUD only.

resultsPatients with OUD in both intervention (N = 7,488) and comparison (N = 7,558) clinics had a mean age of 53 years, and the majority were male, White, and not married. During the pre-implementation period, hospitalization and ED utilization increased over time in both intervention and comparison clinics; during the post-implementation period, hospitalization and ED utilization decreased over time in intervention clinics and remained stable in comparison clinics. There was no significant difference in pre-post changes between intervention and comparison clinics for most analyses. In sensitivity analyses the pre-to-post decrease in monthly trend for ED visits was larger in intervention clinics and, in secondary analyses, the pre-to-post decrease in monthly trend for hospitalizations was larger in intervention clinics among patients with OUD and ≥ 1 other SUD.

conclusionsThis evaluation did not find evidence that SCOUTT substantially impacted hospitalization or ED utilization relative to comparison clinics, though there may have been positive impacts for patients with longer engagement in SCOUTT clinics and patients with OUD and ≥ 1 other SUD.

Indexed as

Emergency Service, HospitalHospitalizationOpiate Substitution TreatmentOpioid-Related DisordersPatient Acceptance of Health CareAdultAgedFemaleHumansInterrupted Time Series AnalysisMaleMiddle AgedUnited StatesUnited States Department of Veterans AffairsVeteransBuprenorphineEmergency departmentHospitalizationImplementationNaltrexoneOpioid use disorderUtilizationVeterans

Identifiers

PMID40140748
PMCPMC11938673

What OpenQuestion holds

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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.