Investigating a Substance Abuse Screening and Brief Intervention in a Trauma Setting (CADSI)
In Orange County, where drug overdose deaths have surged by 61% between 2000-2012, researchers at UCI Medical Center are launching an innovative study to combat substance abuse among trauma patients. With over 773,000 Orange County adults – a staggering 34% of the adult population – having used illicit drugs in their lifetime, this study aims to implement a quick but effective screening tool to identify at-risk patients when they arrive at the trauma center. The research takes advantage of a crucial window of opportunity, as for many patients, their visit to the emergency department may be their only chance to access preventative or interventional services. Through a combination of computerized screening and personalized interventions, the study seeks to replicate the success seen in alcohol screening programs, which have shown up to 47% reduction in hospital readmissions for repeat injuries. By catching substance abuse early and connecting patients with resources during these critical moments, UCI researchers hope to make a significant impact on Orange County’s overdose statistics, which rank among the highest in California alongside Los Angeles and San Diego counties.
Alcohol Risk Assessment Using Computerized Alcohol Screening Instrument in Trauma Patients (TCASI)
At UC Irvine Medical Center’s Level 1 Trauma Center, researchers are tackling a sobering reality – studies show that up to 50% of trauma patients have alcohol in their system when they arrive at the emergency department. In a groundbreaking study examining 11 years of data, UCI researchers aim to understand the complex relationship between patients’ self-reported drinking habits and their actual blood alcohol levels at the time of injury. The research takes advantage of UCI’s innovative Computerized Alcohol Screening and Brief Intervention program, which has already shown promising results – previous studies found that trauma patients who receive alcohol interventions show a remarkable 47% decrease in repeat injuries over three years. What makes this study particularly critical is that trauma patients who have any alcohol in their system are 2.3 times more likely to suffer repeat injuries requiring hospitalization compared to those without alcohol use. By better understanding how patients report their alcohol use compared to actual blood levels, UCI researchers hope to improve screening tools and interventions that could prevent future trauma cases and repeat hospitalizations.
Feasibility of an Emergency-Department-Based Food Insecurity Screening & Referral Program
Food insecurity is a critical but often overlooked health determinant in our Emergency Department. Despite Orange County’s reputation for affluence, our research shows that nearly a quarter of its population lives in poverty, with 12% experiencing unreliable access to sufficient, nutritious food. Our Emergency Department-based screening and referral program aims to bridge the gap between food-insecure patients and available food assistance resources. We hypothesize that many individuals simply lack awareness of local food pantries and support programs, making the ED a crucial intervention point for this vulnerable population. By targeting both direct screening and referral outcomes, we are working to create an evidence-based model that could transform how emergency departments address food insecurity as a core social determinant of health.
Risk Factors Contributing to Motor Vehicle Collisions Among Trauma Patients (BTW)
We examine critical risk factors contributing to motor vehicle collisions (MVCs), accounting for 10.5 emergency department visits per 1,000 patients in the United States. By analyzing a unique combination of patient demographics, medical history, and driving patterns among trauma patients, we aim to identify early intervention opportunities that could prevent future accidents. The study’s multifaceted approach goes beyond traditional accident analysis by incorporating real-time data collection from emergency department patients involved in collisions and those visiting for unrelated reasons. The research team focuses on understanding how lifestyle factors, pre-existing conditions, and medication use may influence collision risk. Through this systematic investigation, the team aims to develop evidence-based educational interventions that can be implemented directly in emergency departments to enhance driving safety across diverse populations.
A randomized controlled study comparing trigger point injections with 1% lidocaine versus 5% lidocaine patch for myofascial pain in the emergency department (TPI vs. LP)
We are investigating whether trigger point injections or lidocaine patches provide better pain relief for patients suffering from myofascial pain in the emergency department. Our previous research revealed promising results with trigger point injections, showing improved pain scores and reduced opioid use. Still, we aim to compare this against the standard lidocaine patch treatment. With up to 78% of emergency department visits involving pain complaints and the ongoing opioid crisis, finding effective non-opioid pain management strategies is crucial for emergency medicine. We are conducting a randomized controlled trial comparing 1% lidocaine trigger point injections to 5% lidocaine patches, tracking patients’ pain levels both during their emergency department stay and for five days afterward. Our goal is to establish evidence-based guidelines for treating myofascial pain while potentially reducing reliance on opioids and other systemic medications that carry significant risks.
Emergency Department Over-Dispensing of Opioid Pills in Wrist Fracture Patients (Wrist Fracture)
The UCI’s Department of Emergency Medicine is examining the critical issue of opioid prescribing patterns in emergency departments, specifically focusing on patients with wrist fractures to determine if doctors are inadvertently contributing to the opioid crisis through over-prescription. Prior studies have suggested that surgical patients often have significant amounts of unused opioid medications. Still, this research team aims to be the first to systematically track precisely how many pills remain unused after emergency department visits for wrist fractures. With over 240 million opioid prescriptions written annually in the U.S., even minor improvements in prescribing practices could have significant public health impacts. The research team is conducting a longitudinal study tracking patients’ real-world opioid usage patterns through their recovery period, aiming to establish evidence-based guidelines for appropriate prescription quantities. By identifying optimal prescribing patterns, the study hopes to reduce the number of excess opioid pills in communities while still ensuring effective pain management for patients.
Exploring Medical Adherence For Emergency Department Patients with Diabetes
One of healthcare’s most pressing challenges is why patients with diabetes don’t take their medications as prescribed, particularly in emergency department settings. Our research is critical, as medication nonadherence affects up to 50% of patients with chronic conditions, resulting in over 100,000 preventable deaths and $100 billion in avoidable medical costs annually. We are specifically focusing on understanding the complex factors that contribute to medication nonadherence among vulnerable populations, including immigrant communities, where adherence rates can be as low as 12%. Through comprehensive surveys examining patients’ beliefs, behaviors, and barriers to medication adherence, we aim to identify key intervention points that could improve health outcomes for diabetic patients. We strive to enroll 324 non-adherent patients to achieve statistically significant results that could help reshape how healthcare providers approach medication adherence support in emergency department settings.
Evaluating Healthcare Access for Homeless Patients Criteria/Methodology
This research aims to understand and address the healthcare needs of Orange County’s homeless population through the UCI Emergency Department, where many unhoused individuals seek care. Our work is particularly timely, as Orange County’s homeless population has grown significantly, with 7,322 individuals reported in the 2024 Point-in-Time count. Through comprehensive surveys and data collection, we are examining the complex barriers to healthcare access, identifying critical gaps in services, and working to challenge common misconceptions about homelessness that may impact the quality of care. As emergency departments often serve as primary access points to healthcare for unhoused individuals, our research aims to inform and improve emergency services while strengthening local street medicine initiatives. By targeting a sample size of 400 participants, we are working to generate statistically significant findings that could reshape how healthcare systems serve this vulnerable population.
Naltrexone Distribution
The UCI Medical Center is prioritizing the identification and treatment of alcohol use disorder using naltrexone, an evidence-based intervention shown to reduce cravings. This initiative aligns with a statewide effort to improve care coordination for patients with substance use disorders. To enhance our Emergency Department discharge metrics, EMRAP will be involved in initiating a protocol to provide “take-home” naltrexone through our Meds to Beds pathway to promote adherence to the medication and improve overall outcomes.