Effectiveness of an Embedded Infectious Disease Screening, Treatment, and Prevention Intervention Within an Inpatient...

Area of Science:

• Infectious Diseases
• Public Health
• Addiction Medicine

Background:

• Individuals with substance use disorders (SUDs) face elevated risks for infectious diseases (IDs).
• Integrating ID screening into inpatient SUD treatment may reduce healthcare access barriers.
• The impact of co-located ID screening in SUD programs requires evaluation.

Purpose of the Study:

• To evaluate the effectiveness of comprehensive infectious disease screening within an inpatient substance use disorder program.
• To assess the impact of a nurse-led intervention on screening completion rates and subsequent treatment uptake.

Main Methods:

• An effectiveness study compared usual care with an intervention involving an ID-trained nurse.
• Screening included HIV, viral hepatitis (HAV, HBV, HCV), latent tuberculosis (LTBI), and sexually transmitted infections (STIs).
• Preventive measures (vaccinations, PrEP) and treatments were offered during admission.

Main Results:

• Screening for at least one ID increased from 60.2% to 90.8% (P < .001).
• Significant increases were observed in screening for HAV (6.1% to 90.3%), HBV (8.8% to 91.3%), and LTBI (1.9% to 67.8%).
• Hepatitis vaccinations increased substantially, and direct-acting antiviral therapy initiation for HCV viremia rose to 36.8%.

Conclusions:

• Comprehensive infectious disease screening is feasible and effective within inpatient SUD settings.
• This integrated approach enhances testing uptake and facilitates low-barrier access to preventive and therapeutic interventions.
• Co-locating ID screening services can improve health outcomes for individuals with SUDs.