ED-based behavioral interventions for opioid use disorders, a mixed-methods study

Research Project Leader
Received Independent Funding
9/1/2018 – 2/28/2020

Francesca Beaudoin, MD, PhD

Associate Professor of Emergency Medicine & Health Services, Policy, and Practice
Director of Clinical Research, Dept. of Emergency Medicine
The Alpert Medical School of Brown University
Rhode Island Hospital and The Miriam Hospital

Tel: 401-444-2577
Email: Francesca_beaudoin@brown.edu

Biography

Dr. Beaudoin is an Associate Professor of Emergency Medicine and Health Services, Policy and Practice. She is a board certified practicing emergency physician and the Director of Clinical Research in the Department of Emergency Medicine at the Alpert Medical School of Brown University. Dr. Beaudoin completed her doctoral degree in Epidemiology at Brown. Her research interests involve the dynamic between acute and chronic pain, and the relationship between pain and substance use disorders. She is focused on how management of acute pain may impact the transition to chronic pain and chronic opioid use.

COBRE Abstract

In response to an accelerating overdose crisis, Rhode Island Hospital has innovated a program for the treatment of opioid use disorders (OUDs) in patients presenting to the emergency department (ED). This program includes an ED-based behavioral intervention (with referrals to treatment) delivered by in-house clinical social work staff or peer recovery coaches (“peer navigators”). Although peer support is an established component of many successful addiction treatment and recovery approaches, the use of peer navigators in the ED setting to care for patients with OUDs is highly novel. The ED-based program is aligned with the goals of the Rhode Island’s strategic plan on addiction and overdose, and works to: (1) reduce the number of opioid overdoses and deaths, (2) increase access to treatment, and (3) increase prevention, treatment and recovery activities for those with drug use disorders.

There is intense interest in peer navigation programs nationwide, but the extent to which a peer-based approach is more efficacious than intervention delivery by extant hospital staff is unknown. Specifically, it is unknown if peer-based programs improve engagement in addiction treatment, promote recovery from OUDs, and prevent recurrent overdose. We have been conducting the Navigator Trial since December 2018 to address the quantitative knowledge gaps as stated above, however additional information is needed about patients declining services and qualitative methodology is needed to illuminate a participant’s thought process and interaction with each intervention. This qualitative approach is an attempt to provide researchers with an understanding regarding the preferences, attitudes, and motivational trends of participants by asking “why” and “how” they perceive the interventions to work.

We are proposing a cohort extension study of the foundation-sponsored RCT (randomized controlled trial) consisting of two groups: (1) the RCT participants, those agreeing to receive an intervention and be randomized, and (2) a “no intervention” control group of participants declining randomization and/or intervention, but willing to consent to follow-up, ongoing record review, and administrative database linkage. This will allow us to determine the impact of any intervention compared to receiving no intervention at all and to assess the impact on patient-reported outcomes (e.g, self-reported overdose, recovery capital). We will also complete one-on-one semi-structured interviews with a subset of 30 patients. Key to this study are interviews with those refusing intervention. Interviews will aim to shed light on how behavioral interventions may or may not align with the physical, social, economic, or political realities of patients in the ED.

Publications

Mentors

Funded Research

Ongoing Research Support

NIA, R21 AG061632 (Beaudoin, Zullo) Pending
Opioid use in post-acute hip fracture care: prescribing patterns, effectiveness, and safety
Role: Co-Principal Investigator

NIDA, R41 DA047837 (Beaudoin)
4/1/2019 – 12/31/19
Mobile Peer-Support for Opioid Use Disorders: Refinement of an Innovative Machine Learning Tool
Role: Principal Investigator

NIGMS, P20 GM125507 (Rich)
9/1/18 – 8/31/19
COBRE Center on Opioids and Overdose
Project: Informed opioid prescribing for acute musculoskeletal pain after motor vehicle collision: A support tool for assessing risks and benefits of analgesic medications before prescribing (STAAMP)
Role: Project PI

Pfizer, B5201002
8/1/18 – 12/31/18
Phase 3, Multicenter, randomized, double-blind, placebo-controlled, parallel-group study to evaluate the efficacy and safety of rivipansel (GMI-1070) in the treatment of vaso-occlusive crisis in hospitalized subjects with sickle cell disease
Role: Site Principal Investigator

NIDA, R34DA045544 (Merchant)
7/1/18 – 6/30/21
Development and pilot testing of a persuasive health communication intervention for emergency department patients who decline rapid HIV/HCV screening
Role: Co-investigator

The Laura and John Arnold Foundation (Beaudoin, Marshall)
7/1/18 – 6/30/22
ED-based behavioral interventions following opioid overdose: The Impact of Peer Navigation on Treatment Engagement, Relapse, and Recovery (The Navigator Trial)
Role: Co-Principal Investigator

NIGMS, U54 GM115677 (Padbury)
5/1/18 – 4/30/19 Advance CTR Project: ED Smart Notifications: Real-time Predictive Modeling of At-Risk Emergency Department Patients was approved by
Role: Project Co-Investigator

NIMH, U01 MH110925 (McLean)
9/23/16 – 7/31/21
Project: Longitudinal Assessment of Post-Traumatic Syndromes (AURORA). Examination of adverse neuropsychiatric sequelae (PTSD, chronic pain) following trauma
Role: Co-Investigator

NINR, R01 NR014782 (Merchant)
7/23/14 – 4/30/19
Project: Facilitating HIV/AIDs and HIV Testing Literacy for Emergency Department Patients
Role: Co-Investigator

Completed (Past 3 Years)

NIGMS, U54 GM115677 (Padbury)
5/1/18 – 12/31/18 Advance CTR Project: Altering the Transition from Acute to Chronic Pain (ATTAC Pain): a randomized clinical trial of duloxetine for the prevention of post-traumatic pain
Role: Project Principal Investigator

Mayday Foundation, 5101277 (Beaudoin / McLean)
4/1/15 – 12/31/18
HELP PAIN: A pilot feasibility RCT to examine the use of the SNRI venlafaxine for the prevention of post-traumatic pain following motor vehicle collision.
Role: Co-Principal Investigator

AHRQ, K12 HS022998 (Lau, Trikalinos)
8/1/15 – 7/31/17
Training in Comparative Effectiveness and Patient Centered Outcomes Research, Institutional Mentored Career Development Program
Center for Evidence Based Medicine, Brown University
Project(s): Treatment effects of emergency department acute pain management after injury – the impact on development of persistent pain and opioid use.
Role: Scholar

Institutional Research Training Grant (Merchant)
7/1/13 – 6/30/15
Society for Academic Emergency Medicine
Brown University Emergency Medicine Substance Abuse Research Fellowship, a 2-year structured, rigorous research training program in substance abuse as related to emergency medicine.
Role: Research Fellow/ Trainee

SURDNA Fellowship Program (Beaudoin)
9/1/13 – 8/30/15
Center for Gerontology and Health Care Research, Brown University; Andrus Family Fund
Funding from this program is used to support an advanced degree in order to further the career of a promising clinician-scientist.
Role: Research Fellow /Trainee

ED-based behavioral interventions for opioid use disorders, a mixed-methods study

Francesca Beaudoin, MD, PhD

Contact

Quick Links