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Hospital Provider's Perspectives on MOUD Initiation and Continuation After Inpatient Discharge
Riley Shearer1, Honora Englander2, Hildi Hagedorn3
1University of Minnesota School of Public Health, Minneapolis, MN, USA.
Journal of General Internal Medicine
|November 25, 2024
Summary
Hospital providers face challenges initiating medications for opioid use disorder (MOUD) due to community treatment barriers. Addressing these gaps is crucial for effective inpatient MOUD programs and patient continuity of care.
Area of Science:
- Addiction Medicine
- Health Services Research
- Implementation Science
Background:
- Opioid use disorder (OUD) is prevalent among hospitalized patients, presenting a key opportunity for treatment initiation.
- Despite this, many patients do not receive medications for opioid use disorder (MOUD) during hospitalization.
- Barriers exist in continuing MOUD post-discharge, impacting treatment effectiveness.
Purpose of the Study:
- To explore hospital providers' perspectives on barriers to initiating and continuing MOUD.
- To inform strategies and policies supporting hospital-based MOUD and community transitions.
Main Methods:
- Semi-structured interviews were conducted with 57 hospital providers across 12 community hospitals.
- Thematic analysis focused on challenges in transitioning patients to outpatient MOUD treatment.
- Study is part of a larger implementation study (NCT#04921787).
Main Results:
- Providers identified structural barriers to outpatient MOUD continuation: limited buprenorphine prescribers, fragmented addiction treatment systems, and long wait times.
- These barriers created a sense of futility, discouraging inpatient MOUD initiation.
- Providers suggested developing hospital-outpatient partnerships and in-reach services.
Conclusions:
- Inadequate and inaccessible community addiction care discourages hospital providers from prescribing MOUD.
- Effective programmatic and policy strategies are needed to improve inpatient-to-outpatient transitions for MOUD.
- Expanding hospital-based opioid treatment requires robust support for community care integration.
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