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OUD MEETS: A novel program to increase initiation of medications for opioid use disorder and improve outcomes for hospitalized patients being discharged to skilled nursing facilities.
J Subst Abuse Treat. 2022 12; 143:108895.JS

Abstract

INTRODUCTION

Rates of hospitalizations from medical complications of opioid use disorder (OUD) are rising and many of these patients require post-acute care at skilled nursing facilities (SNFs). However, access to medication for OUD (MOUD) at SNFs remains low and patients with OUD have high rates of patient-directed discharge (PDD) and hospital readmissions.

METHODS

Opioid Use Disorder Medical Patient Engagement, Enrollment in treatment and Transitional Supports (OUD MEETS) program was a clinical pilot designed to increase initiation of buprenorphine and methadone for hospitalized patients with OUD requiring post-acute care. The program comprises a hospital partnership with two SNFs and two opioid treatment programs (OTPs) to improve recovery supports and access to MOUD for patients discharged to SNF.

RESULTS

Between August 2019 and August 2020, study staff approached 49 hospitalized patients with OUD for participation in OUD MEETS. Twenty-eight of 30 eligible patients enrolled in the program and initiated buprenorphine or methadone. Twenty-seven (96 %) enrolled patients successfully completed hospital treatment. Twenty-three (85 %) patients successfully completed medical treatment at SNF. Thirteen (46 %) enrolled patients had confirmed linkage to OUD treatment post-SNF. One patient left the hospital (4 %) and four patients left SNF (15 %) via PDD.

CONCLUSION

OUD MEETS demonstrates feasibility of hospital, SNF, and OTP partnership to integrate MOUD treatment into SNFs, with high rates of completion of medical treatment and low rates of PDD. Future research should find sustainable ways to improve access to MOUD at post-acute care facilities, including through regulatory and policy changes.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Tassey TE
Behavioral Health Systems Baltimore, Baltimore, MD, United States of America.
Ott GE
Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States of America.
Alvanzo AAH
Division of Addiction Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States of America; Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States of America.
Peirce JM
Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States of America.
Antoine D
Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States of America.
Buresh ME
Division of Addiction Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States of America; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America. Electronic address: mburesh2@jhmi.edu.

MeSH

HumansSkilled Nursing FacilitiesPatient DischargeOpioid-Related DisordersBuprenorphineMethadoneAnalgesics, OpioidOpiate Substitution Treatment

Pub Type(s)

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

Language

eng

PubMed ID

36215913

Citation

Tassey, Theresa E., et al. "OUD MEETS: a Novel Program to Increase Initiation of Medications for Opioid Use Disorder and Improve Outcomes for Hospitalized Patients Being Discharged to Skilled Nursing Facilities." Journal of Substance Abuse Treatment, vol. 143, 2022, p. 108895.
Tassey TE, Ott GE, Alvanzo AAH, et al. OUD MEETS: A novel program to increase initiation of medications for opioid use disorder and improve outcomes for hospitalized patients being discharged to skilled nursing facilities. J Subst Abuse Treat. 2022;143:108895.
Tassey, T. E., Ott, G. E., Alvanzo, A. A. H., Peirce, J. M., Antoine, D., & Buresh, M. E. (2022). OUD MEETS: A novel program to increase initiation of medications for opioid use disorder and improve outcomes for hospitalized patients being discharged to skilled nursing facilities. Journal of Substance Abuse Treatment, 143, 108895. https://doi.org/10.1016/j.jsat.2022.108895
Tassey TE, et al. OUD MEETS: a Novel Program to Increase Initiation of Medications for Opioid Use Disorder and Improve Outcomes for Hospitalized Patients Being Discharged to Skilled Nursing Facilities. J Subst Abuse Treat. 2022;143:108895. PubMed PMID: 36215913.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - OUD MEETS: A novel program to increase initiation of medications for opioid use disorder and improve outcomes for hospitalized patients being discharged to skilled nursing facilities. AU - Tassey,Theresa E, AU - Ott,Geoffrey E, AU - Alvanzo,Anika A H, AU - Peirce,Jessica M, AU - Antoine,Denis, AU - Buresh,Megan E, Y1 - 2022/10/01/ PY - 2022/03/30/received PY - 2022/08/09/revised PY - 2022/09/20/accepted PY - 2022/10/11/pubmed PY - 2022/11/2/medline PY - 2022/10/10/entrez KW - Medications for opioid use disorder KW - Opioid use disorder KW - Patient-directed discharge KW - Skilled nursing facility KW - Transitions of care SP - 108895 EP - 108895 JF - Journal of substance abuse treatment JO - J Subst Abuse Treat VL - 143 N2 - INTRODUCTION: Rates of hospitalizations from medical complications of opioid use disorder (OUD) are rising and many of these patients require post-acute care at skilled nursing facilities (SNFs). However, access to medication for OUD (MOUD) at SNFs remains low and patients with OUD have high rates of patient-directed discharge (PDD) and hospital readmissions. METHODS: Opioid Use Disorder Medical Patient Engagement, Enrollment in treatment and Transitional Supports (OUD MEETS) program was a clinical pilot designed to increase initiation of buprenorphine and methadone for hospitalized patients with OUD requiring post-acute care. The program comprises a hospital partnership with two SNFs and two opioid treatment programs (OTPs) to improve recovery supports and access to MOUD for patients discharged to SNF. RESULTS: Between August 2019 and August 2020, study staff approached 49 hospitalized patients with OUD for participation in OUD MEETS. Twenty-eight of 30 eligible patients enrolled in the program and initiated buprenorphine or methadone. Twenty-seven (96 %) enrolled patients successfully completed hospital treatment. Twenty-three (85 %) patients successfully completed medical treatment at SNF. Thirteen (46 %) enrolled patients had confirmed linkage to OUD treatment post-SNF. One patient left the hospital (4 %) and four patients left SNF (15 %) via PDD. CONCLUSION: OUD MEETS demonstrates feasibility of hospital, SNF, and OTP partnership to integrate MOUD treatment into SNFs, with high rates of completion of medical treatment and low rates of PDD. Future research should find sustainable ways to improve access to MOUD at post-acute care facilities, including through regulatory and policy changes. SN - 1873-6483 UR - https://www.unboundmedicine.com/medline/citation/36215913/OUD_MEETS:_A_novel_program_to_increase_initiation_of_medications_for_opioid_use_disorder_and_improve_outcomes_for_hospitalized_patients_being_discharged_to_skilled_nursing_facilities_ DB - PRIME DP - Unbound Medicine ER -