Multi-method evaluation of a physician-led pilot addiction consult service

Area of Science:

• Hospital-based addiction medicine
• Inpatient substance use disorder care
• Clinical program evaluation

Background:

• Addiction consultation services are specialized hospital programs for patients with substance use disorders (SUDs).
• Evaluating a pilot program's impact on service volume, patient demographics, clinical outcomes, and provider perspectives is crucial for optimizing care.
• Understanding referral patterns and provider challenges informs service improvement.

Purpose of the Study:

• To describe the uptake and patient characteristics of a pilot addiction consultation program.
• To compare clinical outcomes for patients before and after program implementation.
• To explore healthcare provider perceptions, referral patterns, and clinical practices related to addiction consultation.

Main Methods:

• A formative, multi-method evaluation using the RE-AIM framework was conducted at a tertiary care hospital.
• Quantitative data on program uptake and patient demographics were collected via chart review.
• A provider survey assessed practice patterns, perceived needs, roles, and challenges.

Main Results:

• General Internal Medicine accounted for most consult requests (75.1%).
• Consultation significantly increased the odds of receiving pharmacotherapy compared to baseline and non-consult patients (OR 5.82-6.78).
• Providers reported challenges with substance use pharmacotherapy, counseling, and harm reduction, but valued the consult service.

Conclusions:

• The pilot addiction consultation program showed consistent uptake and improved access to pharmacotherapy for hospitalized patients.
• The service supports enhanced inpatient addiction care, with providers recognizing its value beyond medication management.
• Addressing provider confidence and resource navigation remains key for comprehensive SUD care.