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Recommendations for Addressing In-Hospital Substance Use From a National Delphi Consensus Process
Joseph H Donroe1,2, Susan L Calcaterra3, Caty Simon1,4,5
1Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut.
Hospitals lack standardized approaches for in-hospital substance use. This study developed consensus-based recommendations for patient-centered, evidence-based care to address substance use during hospitalization.
Area of Science:
- Addiction Medicine
- Hospital Administration
- Public Health
Background:
- In-hospital substance use, including opioids, stimulants, and cannabis, is common among hospitalized patients.
- Most hospitals lack standardized protocols, potentially leading to patient harm and biased care.
Purpose of the Study:
- To develop best-practice recommendations for addressing in-hospital substance use.
Main Methods:
- A 3-round Delphi process involving clinicians and individuals with lived/living experience (LLE) of substance use disorders.
- Online surveys were used to gather expert opinions and reach consensus on recommendations.
Main Results:
- 84 consensus recommendations were developed, with 58% recommended for universal implementation.
- Key considerations for implementation included patient autonomy, evidence-based care, feasibility, and potential harms.
Conclusions:
- An expert panel established comprehensive recommendations to standardize responses to in-hospital substance use.
- These recommendations aim to promote patient-centered and evidence-based care within hospital settings.
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