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Inpatient Opioid Use Disorder Treatment by Generalists is Associated With Linkage to Opioid Treatment Programs After Discharge.
J Addict Med. 2022 Mar-Apr 01; 16(2):169-176.JA

Abstract

OBJECTIVES

Describe clinical and demographic associations with inpatient medication for opioid use disorder (MOUD) initiation on general medicine services and to examine associations between inpatient MOUD initiation by generalists and subsequent patient healthcare utilization.

METHODS

This is a retrospective study using medical record data from general medicine services at an urban safety-net hospital before an inpatient addiction consultation service. The patients were adults hospitalized for acute medical illness who had an opioid-related ICD-10 code associated with the visit. Associations with MOUD initiation were assessed using multivariable logistic regression. Hospital readmission, emergency department use, linkage to opioid treatment programs (OTP), and mortality at 30- and 90-days postdischarge were compared between those with and without hospital MOUD initiation using χ2 tests.

RESULTS

Of 1,284 hospitalized patients with an opioid-related code, 59.81% received MOUD and 31.38% of these were newly initiated in-hospital. In multivariable logistic regression, Black race, mood disorder, psychotic disorder, and alcohol use disorder were negatively associated with MOUD initiation, while being aged 25-34, having a moderate hospital severity of illness score, and experiencing homelessness were positively associated. There were no bivariate associations between MOUD initiation and postdischarge emergency department use, hospital readmission, or mortality at 30- and 90-days, but those initiated on MOUD were more likely to present to an OTP within 90 days (30.57% vs 12.80%, P < 0.001).

CONCLUSIONS

MOUD prescribing by inpatient generalists may help to increase the number of patients on treatment for opioid use disorder after hospital discharge. More research is needed to understand the impact of inpatient MOUD treatment without addiction specialty consultation.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Tierney HR
School of Medicine, University of California, San Francisco, 500 Parnassus Avenue, San Francisco, CA 94143 (HRT, DAC, POC, HRS); San Francisco Department of Public Health, 25 Van Ness Avenue, Suite 500, San Francisco, CA 94102 (CLR, POC); Department of Family and Community Medicine, University of California, San Francisco, 1001 Potrero Avenue, SFGH 80, San Francisco, CA 94110 (DAC, SS, HRS).
Rowe CL
No affiliation info available
Coffa DA
No affiliation info available
Sarnaik S
No affiliation info available
Coffin PO
No affiliation info available
Snyder HR
No affiliation info available

MeSH

AdultAftercareAnalgesics, OpioidHumansInpatientsOpioid-Related DisordersPatient DischargeRetrospective Studies

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

33813579

Citation

Tierney, Hannah R., et al. "Inpatient Opioid Use Disorder Treatment By Generalists Is Associated With Linkage to Opioid Treatment Programs After Discharge." Journal of Addiction Medicine, vol. 16, no. 2, 2022, pp. 169-176.
Tierney HR, Rowe CL, Coffa DA, et al. Inpatient Opioid Use Disorder Treatment by Generalists is Associated With Linkage to Opioid Treatment Programs After Discharge. J Addict Med. 2022;16(2):169-176.
Tierney, H. R., Rowe, C. L., Coffa, D. A., Sarnaik, S., Coffin, P. O., & Snyder, H. R. (2022). Inpatient Opioid Use Disorder Treatment by Generalists is Associated With Linkage to Opioid Treatment Programs After Discharge. Journal of Addiction Medicine, 16(2), 169-176. https://doi.org/10.1097/ADM.0000000000000851
Tierney HR, et al. Inpatient Opioid Use Disorder Treatment By Generalists Is Associated With Linkage to Opioid Treatment Programs After Discharge. J Addict Med. 2022 Mar-Apr 01;16(2):169-176. PubMed PMID: 33813579.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Inpatient Opioid Use Disorder Treatment by Generalists is Associated With Linkage to Opioid Treatment Programs After Discharge. AU - Tierney,Hannah R, AU - Rowe,Christopher L, AU - Coffa,Diana A, AU - Sarnaik,Shashi, AU - Coffin,Phillip O, AU - Snyder,Hannah R, PY - 2021/4/5/pubmed PY - 2022/3/22/medline PY - 2021/4/4/entrez SP - 169 EP - 176 JF - Journal of addiction medicine JO - J Addict Med VL - 16 IS - 2 N2 - OBJECTIVES: Describe clinical and demographic associations with inpatient medication for opioid use disorder (MOUD) initiation on general medicine services and to examine associations between inpatient MOUD initiation by generalists and subsequent patient healthcare utilization. METHODS: This is a retrospective study using medical record data from general medicine services at an urban safety-net hospital before an inpatient addiction consultation service. The patients were adults hospitalized for acute medical illness who had an opioid-related ICD-10 code associated with the visit. Associations with MOUD initiation were assessed using multivariable logistic regression. Hospital readmission, emergency department use, linkage to opioid treatment programs (OTP), and mortality at 30- and 90-days postdischarge were compared between those with and without hospital MOUD initiation using χ2 tests. RESULTS: Of 1,284 hospitalized patients with an opioid-related code, 59.81% received MOUD and 31.38% of these were newly initiated in-hospital. In multivariable logistic regression, Black race, mood disorder, psychotic disorder, and alcohol use disorder were negatively associated with MOUD initiation, while being aged 25-34, having a moderate hospital severity of illness score, and experiencing homelessness were positively associated. There were no bivariate associations between MOUD initiation and postdischarge emergency department use, hospital readmission, or mortality at 30- and 90-days, but those initiated on MOUD were more likely to present to an OTP within 90 days (30.57% vs 12.80%, P < 0.001). CONCLUSIONS: MOUD prescribing by inpatient generalists may help to increase the number of patients on treatment for opioid use disorder after hospital discharge. More research is needed to understand the impact of inpatient MOUD treatment without addiction specialty consultation. SN - 1935-3227 UR - https://www.unboundmedicine.com/medline/citation/33813579/Inpatient_Opioid_Use_Disorder_Treatment_by_Generalists_is_Associated_With_Linkage_to_Opioid_Treatment_Programs_After_Discharge_ DB - PRIME DP - Unbound Medicine ER -