{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T03:29:40Z","timestamp":1791948580270,"version":"4.3.4"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T00:00:00Z","timestamp":1621382400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R25DA013582"],"award-info":[{"award-number":["R25DA013582"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["shmpublications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Hospital Medicine"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Hospitalized patients with opioid use disorder (OUD) are rarely started on buprenorphine or methadone maintenance despite evidence that these medications reduce all\u2010cause mortality, overdoses, and hospital readmissions.<\/jats:p><\/jats:sec><jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>To assess whether clinician education and a team of residents and hospitalist attendings waivered to prescribe buprenorphine increased the rate of starting patients with OUD on buprenorphine maintenance.<\/jats:p><\/jats:sec><jats:sec><jats:title>DESIGN, SETTING, AND PARTICIPANTS<\/jats:title><jats:p>Quality improvement study conducted at a large, urban, academic hospital in Maryland involving hospitalized patients with OUD on internal medicine resident services.<\/jats:p><\/jats:sec><jats:sec><jats:title>INTERVENTION<\/jats:title><jats:p>We developed a protocol for initiating buprenorphine maintenance, presented an educational conference, and started the resident\u2010led Buprenorphine Bridge Team of residents and attendings waivered to prescribe buprenorphine to bridge patients from discharge to follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>MEASUREMENTS<\/jats:title><jats:p>The percent of eligible inpatients with OUD initiated on buprenorphine maintenance, 24 weeks before and after the intervention; engagement in treatment after discharge; and resident knowledge and comfort with buprenorphine.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The rate of starting buprenorphine maintenance increased from 10% (30 of 305 eligible patients) to 24% (64 of 270 eligible patients) after the intervention, with interrupted time series analysis showing a significant increase in rate (14.4%; 95% CI, 3.6%\u201025.3%; <jats:italic>P<\/jats:italic> = .02). Engagement in treatment after discharge was unchanged (40%\u201046% engaged 30 days after discharge). Of 156 internal medicine residents, 89 (57%) completed the baseline survey and 66 (42%) completed the follow\u2010up survey. Responses demonstrated improved resident knowledge and comfort with buprenorphine.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>Internal medicine resident teams were more likely to start patients on buprenorphine maintenance after clinician education and implementation of a Buprenorphine Bridge Team.<\/jats:p><\/jats:sec>","DOI":"10.12788\/jhm.3544","type":"journal-article","created":{"date-parts":[[2021,6,4]],"date-time":"2021-06-04T10:48:19Z","timestamp":1622803699000},"page":"339-344","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["A Resident\u2010Led Intervention to Increase Initiation of Buprenorphine Maintenance for Hospitalized Patients With Opioid Use Disorder"],"prefix":"10.1002","volume":"16","author":[{"given":"Ashish P","family":"Thakrar","sequence":"first","affiliation":[{"name":"Division of Addiction Medicine Department of Medicine Johns Hopkins University School of Medicine Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Furfaro","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Allergy, and Critical Care Medicine Department of Medicine Columbia University Irving Medical Center\/New York Presbyterian Hospital New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Keller","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine Johns Hopkins University School of Medicine Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Graddy","sequence":"additional","affiliation":[{"name":"AbsoluteCARE Medical Center Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Buresh","sequence":"additional","affiliation":[{"name":"Division of Addiction Medicine Department of Medicine Johns Hopkins University School of Medicine Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard","family":"Feldman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Department of Medicine Johns Hopkins University School of Medicine Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,5,19]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6911a4"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.12788\/jhm.3352"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2015.1424"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhm.2113"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/adm.0000000000000635"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.17226\/25310"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j1550"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.7326\/M17\u20103107"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmra1604339"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/adm.0000000000000499"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2015.09.024"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606\u2010020\u201005815\u20100"},{"key":"e_1_2_6_14_1","doi-asserted-by":"crossref","unstructured":"MadrasBK AhmadNJ WenJ SharfsteinJ;Prevention Treatment and Recovery Working Group of the Action Collaborative on Countering the U.S. Opioid Epidemic.Improving access to evidence\u2010based medical treatment for opioid use disorder: strategies to address key barriers within the treatment system. NAM Perspectives. April 27 2020.https:\/\/doi.org\/10.31478\/202004b","DOI":"10.31478\/202004b"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2018.3685"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/adm.0000000000000496"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40429-019-00267-x"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606\u2010019\u201005251\u20109"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.12788\/jhm.3311"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/adm.0000000000000545"},{"key":"e_1_2_6_21_1","unstructured":"Behavioral health treatment services locator.Substance Abuse and Mental Health Services Administration. Accessed May 14 2020.https:\/\/findtreatment.samhsa.gov\/"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.14423\/smj.0000000000000376"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/mlr.0000000000000805"},{"key":"e_1_2_6_24_1","volume-title":"Initiation and engagement of alcohol and other drug abuse or dependence treatment (IET)"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2019.01.038"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2006.12.015"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/acm.0000000000003053"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2020.108034"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2018.07.008"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.3711"}],"container-title":["Journal of Hospital Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.12788\/jhm.3544","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.12788\/jhm.3544","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/shmpublications.onlinelibrary.wiley.com\/doi\/pdf\/10.12788\/jhm.3544","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T17:26:56Z","timestamp":1760635616000},"score":1,"resource":{"primary":{"URL":"https:\/\/shmpublications.onlinelibrary.wiley.com\/doi\/10.12788\/jhm.3544"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,19]]},"references-count":29,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,6]]}},"alternative-id":["10.12788\/jhm.3544"],"URL":"https:\/\/doi.org\/10.12788\/jhm.3544","archive":["Portico"],"relation":{},"ISSN":["1553-5592","1553-5606"],"issn-type":[{"value":"1553-5592","type":"print"},{"value":"1553-5606","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,19]]},"assertion":[{"value":"2020-06-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}