Note: Student Matched
Primary Investigator: David Horton, MS
Collaborators: Randall Brown, MD, PhD and Tudor Borza, MD
Location of study: Madison
Background information: Shortly after the FDA approved buprenorphine for OUD, the Center for Substance Abuse Treatment (despite acknowledging lack of evidence) indicated that perioperative analgesia would be difficult to achieve with standard opioids if buprenorphine—a partial opioid agonist with very high mu-opioid receptor affinity—were continued. Since that time, expert opinion and non-systematic reviews have called this position into question (e.g., Harrison et al., 2018; Warner NS et al., 2020).
The present study seeks to determine patterns of perioperative MOUD interruption over a period of 10 years, as well as the consequences of MOUD interruption on patient outcomes.
Specifically, the present study would seek to answer the following questions:
- What are the rates of perioperative interruption of MOUD (buprenorphine and methadone), and how have these rates evolved over a period of 10 years?
- What differences in outcomes (if any) exist between patients receiving and patients not receiving their MOUD (i.e., methadone or buprenorphine) within 24 hours of surgery?
- Do interruption rates differ for buprenorphine and methadone, and are these interruptions associated with different outcomes?
What is the potential student role in the project, including clinical time?
Potential roles include statistical analysis of electronic medical record data, organization of data into tables and/or figures, poster/lecture preparation/presentation, and manuscript development/publication. Opportunities for clinical observation of a family physician (study collaborator/Co-Investigator) seeing patients will be available as well.
Additional comments: The study is an electronic medical record (EMR) data analysis study investigating the last 10 years of clinical practice at UW for perioperative pain management of individuals with an Opioid Use Disorder ICD code. The mentee will have opportunities to gain insights into best practices in pain management and perioperative care. Additionally, experience would be available for analyzing and interpreting EMR data, as well as packaging the data collected and analyzed into a presentable format (e.g., poster, paper, presentation).
Clinically, the mentee will have opportunities to observe an experienced family physician seeing patients – either Dr. Randall Brown or other addiction medicine faculty. Dr. Brown is the Founding Director of the UW Addiction Medicine Fellowship Program, among other roles such as Director of the American Board of Addiction Medicine and President of the Addiction Medicine Fellowship Directors’ Association.