The New York City (NYC) Department of Health and Mental Hygiene (DOHMH) has implemented Relay, a novel program that engages and intervenes with individuals in the ED following an opioid OD and for the next 90 days, with the goal of preventing subsequent OD events. The proposed randomized controlled trial will evaluate the impact of Relay on preventing subsequent opioid-related adverse events. A total of 350 eligible individuals with nonfatal opioid OD presenting to one of four participating EDs will be enrolled and randomized to one of two arms: 1) site-directed care (SDC) or 2) Relay-peer-delivered OD education and treatment linkage, including 90 days of peer navigation. Outcomes will be measured for 12 months through interviews and administrative health data.
Relay is a novel program that engages and intervenes with individuals in the ED following an opioid OD and for the next 90 days, with the goal of preventing subsequent OD events. Relay is delivered by trained peer navigators, who are DOHMH staff with lived substance use experience. Relay navigators provide counseling, linkage to services, and OD prevention education.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
253
Relay is a novel program that engages and intervenes with individuals in the ED following an opioid OD and for the next 90 days, with the goal of preventing subsequent OD events. Relay is delivered by trained peer navigators, who are DOHMH staff with lived substance use experience. Relay navigators provide counseling, linkage to services, and OD prevention education.
NYU Langone Health
New York, New York, United States
Number of Opioid-related Adverse Events
Opioid-related adverse events includes fatal and non-fatal opioid-involved overdose as well as substance use-related emergency department (ED) visits. ED visits and fatal overdoses in the 12-month period after baseline will be captured in administrative data sources. Other non-fatal opioid-involved overdose events will be captured by self-report in follow-up interviews through six months after baseline, and estimated for the second half of the 12-month follow-up period.
Time frame: Up to Month 12
Number of Participants Who Initiate Medication for Opioid Use Disorder (MOUD)
MOUD is defined as use of methadone, buprenorphine, or naltrexone that is prescribed by an office-based provider or provided by a treatment program as treatment for OUD. Initiation is defined as receiving MOUD within the 90 days following the index visit, for individuals who received no MOUD for at least 2 weeks prior to the index visit.
Time frame: Up to Month 3
Overdose Risk Behavior Questionnaire Score
13-item questionnaire assessing overdose risk behaviors. Items are rated on a Likert scale from 0 (never) to 4 (very often). The total score is the sum of responses and ranges from 0 to 52; higher scores indicate more prevalent overdose risk behaviors.
Time frame: Baseline
Overdose Risk Behavior Questionnaire Score
13-item questionnaire assessing overdose risk behaviors. Items are rated on a Likert scale from 0 (never) to 4 (very often). The total score is the sum of responses and ranges from 0 to 52; higher scores indicate more prevalent overdose risk behaviors.
Time frame: Month 1
Overdose Risk Behavior Questionnaire Score
13-item questionnaire assessing overdose risk behaviors. Items are rated on a Likert scale from 0 (never) to 4 (very often). The total score is the sum of responses and ranges from 0 to 52; higher scores indicate more prevalent overdose risk behaviors.
Time frame: Month 3
Overdose Risk Behavior Questionnaire Score
13-item questionnaire assessing overdose risk behaviors. Items are rated on a Likert scale from 0 (never) to 4 (very often). The total score is the sum of responses and ranges from 0 to 52; higher scores indicate more prevalent overdose risk behaviors.
Time frame: Month 6
Time to Next Opioid-Involved Overdose
Time to next opioid-involved overdose from the time of baseline, by self-report.
Time frame: Up to Month 6
Number of Emergency Deparment (ED) Visits for Any Cause
Frequency of ED visits for any cause (including visits that are not substance use-related) will be measured, using administrative data, to assess whether there are differences in overall acute care use representing potentially negative health events.
Time frame: Up to Month 12
Number of ED Visits for Other (Non-OD) Substance Use Reasons
Frequency of ED visits for other (non-OD) substance use will be measured, using administrative data.
Time frame: Up to Month 12
Number of Opioid Overdose-Related ED Visits
Frequency of ED visits for opioid overdose will be measured, using administrative data
Time frame: Up to Month 12
Percentage of Participants Who Self-Report Opioid-Involved Overdose
Includes non-fatal overdose that did or did not result in an ED visit, by self report.
Time frame: Month 1
Percentage of Participants Who Self-Report Opioid-Involved Overdose
Includes non-fatal overdose that did or did not result in an ED visit, by self report.
Time frame: Month 3
Percentage of Participants Who Self-Report Opioid-Involved Overdose
Includes non-fatal overdose that did or did not result in an ED visit, by self report.
Time frame: Month 6
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.