Improving Linkage for Patients With Injection-Drug-Use-Related Endocarditis and Osteomyelitis to Medications for...

Area of Science:

• Infectious Diseases
• Public Health
• Addiction Medicine

Background:

• The opioid overdose crisis is linked to rising injection-related infections like endocarditis and osteomyelitis.
• Standard treatment requires long-term intravenous antibiotics, often via peripherally inserted central venous catheters (PICCs).
• PICCs in patients with opioid use disorder (OUD) are concerning due to potential for illicit substance use, complicating home antibiotic completion and leading to prolonged hospitalization or skilled nursing facility (SNF) stays.

Purpose of the Study:

• To improve linkage to outpatient medication for opioid use disorder (MOUD) services for patients completing antibiotic treatment in SNFs.
• To address challenges in coordinating MOUD care during transitions from SNFs.

Main Methods:

• A quality improvement project implemented a telephone intervention to connect patients to outpatient MOUD services upon SNF discharge.
• The intervention targeted 11 patients qualifying for the program.

Main Results:

• During SNF stay, 57.1% (4/7) of patients were successfully contacted.
• Post-SNF discharge, only 30.0% (3/10) of patients were reached.
• All patients contacted post-discharge attended their outpatient MOUD appointments.

Conclusions:

• Telephone interventions showed limited success in linking patients to outpatient MOUD services.
• Future interventions may be more effective using existing care team members to leverage established rapport for better linkage.
• Improving care coordination is crucial for patients with OUD and injection-related infections.