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Addiction Consult Service and Inpatient Outcomes Among Patients with OUD
Andrea Jakubowski1, Sumeet Singh-Tan2, Kristine Torres-Lockhart3
1Division of General Internal Medicine, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA. ajakubow@montefiore.org.
Journal of General Internal Medicine
|August 13, 2024
Summary
Addiction consult services (ACSs) significantly increase inpatient medication for opioid use disorder (MOUD) initiation and post-discharge linkage. These services promote evidence-based care for opioid use disorder (OUD).
Area of Science:
- Addiction Medicine
- Hospital Medicine
- Public Health
Background:
- Hospitalizations for opioid use disorder (OUD) are rising, yet inpatient medication for OUD (MOUD) initiation remains low.
- Addiction consult services (ACSs) aim to improve MOUD initiation and post-discharge care but require rigorous outcome evaluation.
Purpose of the Study:
- To assess the association between ACS consultation and inpatient MOUD initiation.
- To evaluate the impact of ACSs on discharge MOUD provision and post-discharge MOUD linkage.
Main Methods:
- Retrospective study comparing 100 patients receiving ACS consults with 100 propensity score-matched historical controls.
- Outcomes included inpatient MOUD initiation (methadone/buprenorphine), discharge prescriptions, and post-discharge linkage within 30-60 days.
Main Results:
- ACS consultation was associated with significantly higher inpatient MOUD initiation (OR 2.57).
- ACSs strongly correlated with inpatient buprenorphine initiation (OR 5.50), discharge buprenorphine prescriptions (OR 17.22), and post-discharge linkage.
- Significant increases were observed in buprenorphine prescriptions within 60 days (22.0% vs. 0.0%) and methadone administration within 30 days (7.0% vs. 0.0%).
Conclusions:
- ACS consultation demonstrates a strong association with improved inpatient MOUD initiation and post-discharge MOUD linkage.
- ACSs are effective in promoting evidence-based care delivery for patients with OUD.
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