View in EDS HTML Full Text PDF Full Text

Adapting to the Fentanyl Epidemic: Rapid Qualitative Observations and Derived Clinical and Research Implications from the Emergency Department Longitudinal Integrated Care (ED-LINC) Randomized Clinical Trial.

Saved in:
Bibliographic Details
Title: Adapting to the Fentanyl Epidemic: Rapid Qualitative Observations and Derived Clinical and Research Implications from the Emergency Department Longitudinal Integrated Care (ED-LINC) Randomized Clinical Trial.
Authors: Lovett, Kayla (AUTHOR), Zatzick, Douglas (AUTHOR), Palinkas, Lawrence A. (AUTHOR), Engstrom, Allison (AUTHOR), Nye, Emily (AUTHOR), Field, Craig (AUTHOR), McGovern, Mark (AUTHOR), Parrish, Canada (AUTHOR), Banta-Green, Caleb J. (AUTHOR), Whiteside, Lauren K. (AUTHOR)
Source: Psychiatry: Interpersonal & Biological Processes. Winer2025, Vol. 88 Issue 4, p333-350. 18p.
Subjects: Suicide risk factors, Drug overdose, Substance abuse, Medical protocols, Patient compliance, Patients, Interprofessional relations, Human services programs, Secondary analysis, Safety-net health care providers, Research funding, Participant observation, Questionnaires, Field notes (Science), Hospital emergency services, Emergency medical services, Descriptive statistics, Thematic analysis, Research methodology, Survival analysis (Biometry), Needs assessment, Drugs, Fentanyl, Integrated health care delivery, Disease complications
Geographic Terms: Washington (State)
Abstract: Objective: The Emergency Department Longitudinal Integrated Care (ED-LINC) randomized clinical trial (NCT05327166) tests a Collaborative Care-informed intervention for emergency department (ED) patients with opioid use disorder. The ED-LINC intervention was developed before the current fentanyl epidemic; less than 10% of ED-LINC pilot intervention patients reported fentanyl use. To understand fentanyl's impact on the ED-LINC protocol, we utilized a systematic rapid qualitative approach to document clinical observations related to ED-LINC patients' fentanyl use and subsequent protocol modifications. Method: This study utilized Rapid Assessment Procedure Informed Clinical Ethnography (RAPICE) methods to document fentanyl-related clinical observations. As participant observers, the team worked with a mixed methods consultant to analyze observations, informing adaptation to study protocol and intervention. Results: From 4/12/2022 to 2/10/2023, 86 patients enrolled in the ED-LINC trial. Forty received the ED-LINC intervention and are included in this study. Investigators identified the following themes informing adaptation to the ED-LINC intervention: 1) fentanyl-related suicide risk, 2) fentanyl-catalyzed approach to Medications for Opioid Use Disorder (MOUD), 3) fentanyl-related adaptations to measurement-based care embedded in the Collaborative Care approach, 4) fentanyl-associated survival needs, and 5) engagement challenges with fentanyl. Adaptations included incorporating overdose prevention into suicide risk assessment, nontraditional MOUD induction, and shifting to a component-driven model. Conclusions: The landscape of clinical practice can change quickly and may require both researchers and healthcare providers to quickly pivot. Rapid assessment procedures integrated into clinical trial investigation allow for modifications and adaptations to study protocols to ensure salient and generalizable results given the rapidly evolving opioid epidemic. [ABSTRACT FROM AUTHOR]
Copyright of Psychiatry: Interpersonal & Biological Processes is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
Full text is not displayed to guests.
FullText Links:
  – Type: pdflink
Text:
  Availability: 1
Header DbId: pbh
DbLabel: Psychology and Behavioral Sciences Collection
An: 189877305
AccessLevel: 6
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Adapting to the Fentanyl Epidemic: Rapid Qualitative Observations and Derived Clinical and Research Implications from the Emergency Department Longitudinal Integrated Care (ED-LINC) Randomized Clinical Trial.
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Lovett%2C+Kayla%22">Lovett, Kayla</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Zatzick%2C+Douglas%22">Zatzick, Douglas</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Palinkas%2C+Lawrence+A%2E%22">Palinkas, Lawrence A.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Engstrom%2C+Allison%22">Engstrom, Allison</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Nye%2C+Emily%22">Nye, Emily</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Field%2C+Craig%22">Field, Craig</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22McGovern%2C+Mark%22">McGovern, Mark</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Parrish%2C+Canada%22">Parrish, Canada</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Banta-Green%2C+Caleb+J%2E%22">Banta-Green, Caleb J.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Whiteside%2C+Lauren+K%2E%22">Whiteside, Lauren K.</searchLink> (AUTHOR)
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="JN" term="%22Psychiatry%3A+Interpersonal+%26+Biological+Processes%22">Psychiatry: Interpersonal & Biological Processes</searchLink>. Winer2025, Vol. 88 Issue 4, p333-350. 18p.
– Name: Subject
  Label: Subjects
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Suicide+risk+factors%22">Suicide risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22Drug+overdose%22">Drug overdose</searchLink><br /><searchLink fieldCode="DE" term="%22Substance+abuse%22">Substance abuse</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+protocols%22">Medical protocols</searchLink><br /><searchLink fieldCode="DE" term="%22Patient+compliance%22">Patient compliance</searchLink><br /><searchLink fieldCode="DE" term="%22Patients%22">Patients</searchLink><br /><searchLink fieldCode="DE" term="%22Interprofessional+relations%22">Interprofessional relations</searchLink><br /><searchLink fieldCode="DE" term="%22Human+services+programs%22">Human services programs</searchLink><br /><searchLink fieldCode="DE" term="%22Secondary+analysis%22">Secondary analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Safety-net+health+care+providers%22">Safety-net health care providers</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Participant+observation%22">Participant observation</searchLink><br /><searchLink fieldCode="DE" term="%22Questionnaires%22">Questionnaires</searchLink><br /><searchLink fieldCode="DE" term="%22Field+notes+%28Science%29%22">Field notes (Science)</searchLink><br /><searchLink fieldCode="DE" term="%22Hospital+emergency+services%22">Hospital emergency services</searchLink><br /><searchLink fieldCode="DE" term="%22Emergency+medical+services%22">Emergency medical services</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Thematic+analysis%22">Thematic analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Research+methodology%22">Research methodology</searchLink><br /><searchLink fieldCode="DE" term="%22Survival+analysis+%28Biometry%29%22">Survival analysis (Biometry)</searchLink><br /><searchLink fieldCode="DE" term="%22Needs+assessment%22">Needs assessment</searchLink><br /><searchLink fieldCode="DE" term="%22Drugs%22">Drugs</searchLink><br /><searchLink fieldCode="DE" term="%22Fentanyl%22">Fentanyl</searchLink><br /><searchLink fieldCode="DE" term="%22Integrated+health+care+delivery%22">Integrated health care delivery</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+complications%22">Disease complications</searchLink>
– Name: SubjectGeographic
  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Washington+%28State%29%22">Washington (State)</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: The Emergency Department Longitudinal Integrated Care (ED-LINC) randomized clinical trial (NCT05327166) tests a Collaborative Care-informed intervention for emergency department (ED) patients with opioid use disorder. The ED-LINC intervention was developed before the current fentanyl epidemic; less than 10% of ED-LINC pilot intervention patients reported fentanyl use. To understand fentanyl's impact on the ED-LINC protocol, we utilized a systematic rapid qualitative approach to document clinical observations related to ED-LINC patients' fentanyl use and subsequent protocol modifications. Method: This study utilized Rapid Assessment Procedure Informed Clinical Ethnography (RAPICE) methods to document fentanyl-related clinical observations. As participant observers, the team worked with a mixed methods consultant to analyze observations, informing adaptation to study protocol and intervention. Results: From 4/12/2022 to 2/10/2023, 86 patients enrolled in the ED-LINC trial. Forty received the ED-LINC intervention and are included in this study. Investigators identified the following themes informing adaptation to the ED-LINC intervention: 1) fentanyl-related suicide risk, 2) fentanyl-catalyzed approach to Medications for Opioid Use Disorder (MOUD), 3) fentanyl-related adaptations to measurement-based care embedded in the Collaborative Care approach, 4) fentanyl-associated survival needs, and 5) engagement challenges with fentanyl. Adaptations included incorporating overdose prevention into suicide risk assessment, nontraditional MOUD induction, and shifting to a component-driven model. Conclusions: The landscape of clinical practice can change quickly and may require both researchers and healthcare providers to quickly pivot. Rapid assessment procedures integrated into clinical trial investigation allow for modifications and adaptations to study protocols to ensure salient and generalizable results given the rapidly evolving opioid epidemic. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Psychiatry: Interpersonal & Biological Processes is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=189877305
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1080/00332747.2025.2472429
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 18
        StartPage: 333
    Subjects:
      – SubjectFull: Suicide risk factors
        Type: general
      – SubjectFull: Drug overdose
        Type: general
      – SubjectFull: Substance abuse
        Type: general
      – SubjectFull: Medical protocols
        Type: general
      – SubjectFull: Patient compliance
        Type: general
      – SubjectFull: Patients
        Type: general
      – SubjectFull: Interprofessional relations
        Type: general
      – SubjectFull: Human services programs
        Type: general
      – SubjectFull: Secondary analysis
        Type: general
      – SubjectFull: Safety-net health care providers
        Type: general
      – SubjectFull: Research funding
        Type: general
      – SubjectFull: Participant observation
        Type: general
      – SubjectFull: Questionnaires
        Type: general
      – SubjectFull: Field notes (Science)
        Type: general
      – SubjectFull: Hospital emergency services
        Type: general
      – SubjectFull: Emergency medical services
        Type: general
      – SubjectFull: Descriptive statistics
        Type: general
      – SubjectFull: Thematic analysis
        Type: general
      – SubjectFull: Research methodology
        Type: general
      – SubjectFull: Survival analysis (Biometry)
        Type: general
      – SubjectFull: Needs assessment
        Type: general
      – SubjectFull: Drugs
        Type: general
      – SubjectFull: Fentanyl
        Type: general
      – SubjectFull: Integrated health care delivery
        Type: general
      – SubjectFull: Disease complications
        Type: general
      – SubjectFull: Washington (State)
        Type: general
    Titles:
      – TitleFull: Adapting to the Fentanyl Epidemic: Rapid Qualitative Observations and Derived Clinical and Research Implications from the Emergency Department Longitudinal Integrated Care (ED-LINC) Randomized Clinical Trial.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Lovett, Kayla
      – PersonEntity:
          Name:
            NameFull: Zatzick, Douglas
      – PersonEntity:
          Name:
            NameFull: Palinkas, Lawrence A.
      – PersonEntity:
          Name:
            NameFull: Engstrom, Allison
      – PersonEntity:
          Name:
            NameFull: Nye, Emily
      – PersonEntity:
          Name:
            NameFull: Field, Craig
      – PersonEntity:
          Name:
            NameFull: McGovern, Mark
      – PersonEntity:
          Name:
            NameFull: Parrish, Canada
      – PersonEntity:
          Name:
            NameFull: Banta-Green, Caleb J.
      – PersonEntity:
          Name:
            NameFull: Whiteside, Lauren K.
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 12
              Text: Winer2025
              Type: published
              Y: 2025
          Identifiers:
            – Type: issn-print
              Value: 00332747
          Numbering:
            – Type: volume
              Value: 88
            – Type: issue
              Value: 4
          Titles:
            – TitleFull: Psychiatry: Interpersonal & Biological Processes
              Type: main
ResultId 1