Proactive Addiction Consultation for Hospitalized Patients With Opioid Use Disorder: A Pilot Study

Area of Science:

• Addiction Psychiatry
• Hospital Medicine
• Public Health

Background:

• Opioid use disorder (OUD) presents significant morbidity and mortality, necessitating early intervention in hospitalized patients.
• Proactive consultation-liaison psychiatry models can improve access to care for patients with OUD.
• The impact of proactive addiction consultation on clinical outcomes remains understudied.

Purpose of the Study:

• To evaluate the effectiveness of a proactive addiction consultation model in a pilot study for hospitalized patients with OUD.
• To assess the impact of this intervention on service delivery and key clinical outcomes.

Main Methods:

• A quasi-randomized controlled pilot study was conducted on hospitalized patients with likely OUD.
• The intervention involved proactive prompts for addiction consultation, compared to usual care where consultations were independently requested.
• Secondary outcomes included OUD medication initiation, AMA discharge, ER utilization, and readmission rates.

Main Results:

• Patients receiving proactive consultation were significantly more likely to complete consultations (54.8% vs. 16.2%).
• No significant differences were observed in secondary outcomes between the intervention and control groups.
• However, patients who received an addiction consultation (regardless of group) were more likely to receive OUD medication (61.2% vs. 29.3%).

Conclusions:

• A proactive model for suggesting addiction consultations increases consultation completion rates in hospitalized patients with OUD.
• Addiction consultations are associated with the initiation or continuation of medication for OUD, highlighting their value.
• Further research is required to determine the impact of addiction consultation services on broader health outcomes.