A Scoping Review and Consensus Recommendations for Emergency Medical Services Buprenorphine (EMS-Bupe) Programs.

Area of Science:

• Emergency medicine
• Addiction medicine
• Public health

Background:

• Emergency Medical Services (EMS) agencies are increasingly offering low-barrier treatment for opioid use disorder (OUD) via buprenorphine programs (EMS-Bupe).
• A lack of evidence-based practices currently exists for these emerging EMS-Bupe programs.
• Standardized protocols are needed for effective program development and implementation.

Purpose of the Study:

• To conduct a scoping review of existing EMS-buprenorphine and emergency department (ED) medication for OUD programs.
• To generate consensus-based recommendations for the development of EMS-Bupe programs.
• To address the variability observed in current EMS-Bupe program structures and practices.

Main Methods:

• A comprehensive scoping review was performed on EMS-Bupe and ED MOUD programs.
• Searches included major databases (Ovid MEDLINE, Embase, Cochrane, Web of Science) for English language articles and abstracts.
• Consensus recommendations were formulated based on review findings and supplementary literature.

Main Results:

• The review identified 9 EMS-Bupe articles/abstracts and 21 ED MOUD abstracts, detailing 5 EMS-Bupe programs across 4 states.
• Significant program variability was noted in infrastructure, buprenorphine dosing, and patient retention rates.
• Results were categorized into 8 key areas, including program infrastructure, eligibility criteria, dosing, clinician training, and data management.

Conclusions:

• Limited data on EMS-Bupe programs highlight considerable variability.
• Recommendations emphasize community engagement, establishing local resource partnerships, and optimizing protocols for patient eligibility and retention.
• Low-barrier, patient-centered strategies are crucial for preventing treatment gaps and ensuring continuity of care.