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Area of Science:

  • Implementation science
  • Prehospital care
  • Opioid use disorder treatment

Background:

  • Medication for opioid use disorder (MOUD) significantly reduces harm for patients with opioid use disorder (OUD).
  • Recent policy changes enable prehospital MOUD delivery.
  • Fire department EMS Mobile Integrated Health (MIH) programs offer a novel approach to OUD care.

Purpose of the Study:

  • To evaluate the reach of a fire department EMS-based MIH program providing prehospital MOUD.
  • To assess patient engagement and buprenorphine induction rates within this program.

Main Methods:

  • The West Allis Fire Department's MIH program utilized internal and external referrals for OUD patients.
  • Data collected included overall patient contact, COWS scores, buprenorphine offers, and inductions.
  • Referral sources included 9-1-1 dispatch, self-referrals, electronic patient care reports, EDs, and community partners.

Main Results:

  • The program received 265 potential referrals, with 128 patient contacts made (48.3% reach).
  • Overall reach was 77.3%, with 100% COWS Reach.
  • Buprenorphine induction reach was 8.1% (8/99 offered), with 50% acceptance (4/8).

Conclusions:

  • Fire department EMS-based MIH programs can effectively reach patients with OUD.
  • External referrals are crucial for program reach.
  • Challenges include real-time assessment, patient eligibility, and buprenorphine acceptance rates.