DOI: 10.3886/icpsr38568.v1
title: EMBED: A Pragmatic Trial of User Centered Clinical Decision Support for EMergency Department Initiated BuprenorphinE for Opioid Use Disorder, 5 U.S. states, 2019-2021
title: Version 1

description: Buprenorphine (BUP) is a highly efficacious drug for treatment of addiction for Opioid Use Disorder (OUD) patients. Although it is safe and effective to initiate this treatment in the emergency departments (ED) where a lot of OUD patients seek care, due to challenges related to lack of knowledge, etc. this practice has not been widely adopted. The goal of this trial was to test the efficacy of a user centered clinical decision support (CDS) tool (EMBED) that was developed to facilitate ED clinicians to administer/prescribe BUP for OUD patients presenting to the ED. This was an 18-month long, pragmatic, parallel, group randomized trial implemented across 18 ED clusters (21 sites) in 5 healthcare systems randomly allocated in 1:1 ratio to intervention versus usual care arm. For the intervention, CDS was to support diagnosis and withdrawal assessment and automate electronic health record (EHR) documentation. The primary outcome was the initiation of BUP in ED at patient level.
description: The purpose of this study was to test the efficacy of a user centered clinical decision support (CDS) tool (EMBED) that was developed to facilitate emergency department (ED) clinicians to administer/prescribe Buprenorphine for Opioid Use Disorder patients presenting to the ED.
description: This study contains variables regarding the reason for participants' emergency department (ED) visits, what occurred during the ED visit, demographics of participants and providers, and variables about the use of Buprenorphine.
description: The study sample was derived from all patient visits to the participating 18 emergency department (ED) clusters, across 5 healthcare systems in Alabama, Colorado, Connecticut, Massachusetts, and North Carolina, during November 2019 to May 2021. These 18 clusters included 21 ED sites, with 3 sites paired with a second ED within the same healthcare system due to low patient volume and/or high physician crossover rates between the 2 sites. Randomization was performed at the level of ED cluster, in a 1:1 ratio with clusters assigned to receive either the intervention or usual care.
description: Datasets: DS1: EMBED: A Pragmatic Trial of User Centered Clinical Decision Support for EMergency Department Initiated BuprenorphinE for Opioid Use Disorder, 5 U.S. states, 2019-2021
description: Patients aged 18 or older in 21 emergency department (ED) sites in 5 healthcare systems in 5 states, with probable Opioid Use Disorder (OUD) who were discharged from the ED, not pregnant, and not currently on medication for OUD as documented in the electronic health record.
description: record abstractsOutcome data was collected via SQL query of the local Electronic Health Records (EHR) at each healthcare system at regular intervals from data routinely collected in each hospital's EHR.To enable consistent Electronic Health Records (EHR) data collection across sites, a master data dictionary of all data elements was created. Please see the zipped documentation.At each study site, the variables in the data dictionary were validated against the institutional Electronic Health Records (EHR) to ensure that the variables are correctly mapped to the EHR field that corresponds to the clinical intent of the variable after accounting for documentation practices and workflow at each site. For data quality assurance, the mapped variables were validated against the EHR to ensure that the data are clinically relevant to the goals of the project and correctly represents the clinical data that clinicians use to make decisions.