Decision Support for Opioid Use Disorder

This trial aims to improve how emergency department doctors treat patients with opioid use disorder. It tests a new system, Refined EMBED CDS, which helps doctors follow treatment guidelines, particularly with buprenorphine, a medication for opioid addiction. The trial consists of two parts: one uses the EMBED system with a nurse prompt, while the other uses only the EMBED system. Suitable participants have moderate to severe opioid use disorder and seek help in an emergency department. As an unphased trial, this study provides a unique opportunity to contribute to innovative approaches in emergency care for opioid use disorder.

If you are currently receiving medication for opioid use disorder, you cannot participate in this trial.

Research has shown that the EMBED clinical decision support (CDS) tools are designed to help doctors treat opioid use disorder (OUD) more effectively. Studies have demonstrated that these tools assist in using buprenorphine, a medication already approved and considered safe for managing OUD. Buprenorphine reduces cravings and the risk of overdose, making it a trusted choice for many healthcare providers.

Researchers are excited about this trial because it's exploring a new way to help manage opioid use disorder by using decision support systems in healthcare settings. Unlike traditional treatments that focus primarily on medication-assisted therapies like methadone or buprenorphine, this trial is testing the effectiveness of the Refined EMBED CDS, a clinical decision support tool, which aims to enhance the decision-making process for healthcare providers. One distinctive feature is the integration of nurse prompts to ensure comprehensive assessment, which could lead to more personalized and timely interventions. This approach could potentially change how care is delivered by making it more efficient and tailored to individual patient needs, which is why researchers are keen to see the outcomes.

Research shows that the EMBED clinical decision support (CDS) system helps emergency room doctors initiate buprenorphine treatment for patients with opioid use disorder (OUD). Buprenorphine safely and effectively reduces cravings, overdoses, and death rates in people with OUD. The EMBED system aims to assist doctors in following best practices when prescribing buprenorphine. Although one study found that an earlier version of EMBED did not affect treatment rates, ongoing improvements aim to enhance its effectiveness. In this trial, participants will be in one of two groups: one receiving the updated Refined EMBED CDS and another receiving the Refined EMBED plus a nurse prompt to complete COWS documentation. The updated EMBED CDS is designed to increase the number of doctors adhering to standard care guidelines, potentially leading to better patient outcomes through more consistent treatment.¹⁶⁷⁸⁹