Ellen F Eaton1, Rachael A Lee1, Andrew O Westfall2, R E Mathews3, Brandi McCleskey4, Cayce S Paddock5, Peter S Lane5, Karen L Cropsey5. 1. Department of Medicine, Division of Infectious Diseases University of Alabama at Birmingham, Birmingham, Alabama, USA. 2. Department of Biostatistics, Ryals School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA. 3. Department of Medicine, Division of Hospital Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. 4. Department of Pathology, Division of Forensics, University of Alabama at Birmingham, Birmingham, Alabama, USA. 5. Department of Psychiatry, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Abstract
BACKGROUND: Hospital-based strategies that link persons with infectious complications of opioid use disorder (OUD) to medications for OUD (MOUD) are of great interest. The objective of this study is to determine whether a hospital-based protocol would increase the use of MOUD and to identify barriers to MOUD during admission and at the time of discharge. METHODS: This study included participants with a documented or suspected history of injection drug usage receiving care for an infection at the University of Alabama at Birmingham Hospital from 2015 to 2018. The protocol, the intravenous antibiotic and addiction team (IVAT), included Addiction Medicine and Infectious Diseases consultation and a 9-item risk assessment. We quantified MOUD use before and after IVAT and used logistic regression to determine factors associated with MOUD. We explored barriers to MOUD uptake using chart review. RESULTS: A total of 37 and 98 patients met criteria in the pre- and post-IVAT periods, respectively. With IVAT, the percentage with OUD receiving MOUD significantly increased (29% pre-IVAT and 37% post-IVAT; P = .026) and MOUD use was higher in "high risk" participants (62%). Clinical and sociodemographic factors were not associated with MOUD receipt. CONCLUSIONS: A hospital-based protocol may increase the use of MOUD; however, the uptake of MOUD remains suboptimal (<50%).
BACKGROUND: Hospital-based strategies that link persons with infectious complications of opioid use disorder (OUD) to medications for OUD (MOUD) are of great interest. The objective of this study is to determine whether a hospital-based protocol would increase the use of MOUD and to identify barriers to MOUD during admission and at the time of discharge. METHODS: This study included participants with a documented or suspected history of injection drug usage receiving care for an infection at the University of Alabama at Birmingham Hospital from 2015 to 2018. The protocol, the intravenous antibiotic and addiction team (IVAT), included Addiction Medicine and Infectious Diseases consultation and a 9-item risk assessment. We quantified MOUD use before and after IVAT and used logistic regression to determine factors associated with MOUD. We explored barriers to MOUD uptake using chart review. RESULTS: A total of 37 and 98 patients met criteria in the pre- and post-IVAT periods, respectively. With IVAT, the percentage with OUD receiving MOUD significantly increased (29% pre-IVAT and 37% post-IVAT; P = .026) and MOUD use was higher in "high risk" participants (62%). Clinical and sociodemographic factors were not associated with MOUD receipt. CONCLUSIONS: A hospital-based protocol may increase the use of MOUD; however, the uptake of MOUD remains suboptimal (<50%).
Authors: Nathanial S Nolan; Emily Gleason; Laura R Marks; Tracey Habrock-Bach; Stephen Y Liang; Michael J Durkin Journal: Front Psychiatry Date: 2022-06-21 Impact factor: 5.435
Authors: Alison M Beieler; Jared W Klein; Elenore Bhatraju; Matthew Iles-Shih; Leslie Enzian; Shireesha Dhanireddy Journal: Open Forum Infect Dis Date: 2021-05-29 Impact factor: 3.835