Journal of general internal medicine · 2026
Impact of Medication for Opioid Use Disorder on Patient Directed Discharge Among Patients with Opioid Use Disorder.
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Singh-Tan Sumeet, Jakubowski Andrea, Reicher Zina Huxley, Torres-Lockhart Kristine, Ceresnak Jeffrey, Pacifico Jessica, Arnsten Julia, Southern William
Аннотация
BACKGROUND: Opioid use disorder (OUD) is responsible for significant morbidity and mortality in the USA. Hospitalization rates for patients with OUD have increased over the recent decades. Those with OUD have a substantially higher rate of patient-directed discharge (PDD) than those without OUD. There have been mixed results when examining the association between inpatient MOUD and PDD.
OBJECTIVE: To determine the association between inpatient MOUD and the rate of PDD among patients without evidence of MOUD treatment prior to hospitalization.
DESIGN: Retrospective study comparing admissions receiving inpatient MOUD and propensity score-matched control admissions who did not receive MOUD.
SUBJECTS: Two thousand seven hundred seventy-one admissions with a diagnosis of OUD and without evidence of prior MOUD treatment were compared to 2771 propensity-matched admissions.
INTERVENTION: Provision of inpatient MOUD, either buprenorphine or methadone during admission.
MAIN MEASURES: Primary outcome was patient-directed discharge. Secondary outcomes were buprenorphine prescription at discharge, buprenorphine prescription within 60 days of discharge, admission into an outpatient methadone program within 30 days of discharge, 30-day readmission, and 30-day post-discharge ED visit.
KEY RESULTS: Among 5542 admissions with OUD and no evidence of MOUD prior to admission, those that received inpatient MOUD were significantly less likely to have a PDD (11.9% vs 14.4%; OR 0.80 [CI 0.67-0.96]) and significantly more likely to receive a discharge prescription for buprenorphine (8.6% vs 1.2%; OR 8.04 [CI 5.52-11.71]) and another buprenorphine prescription within 60 days of discharge (5.5% vs 1.1%; OR 5.09 [CI 3.35-7.74]), compared with control admissions who did not receive MOUD. Inpatient MOUD was not significantly associated with admission into an outpatient methadone program within 30 days, 30-day readmission, and 30-day post-discharge ED visit.
CONCLUSIONS: Receipt of inpatient MOUD was associated with a statistically significant reduction in PDD among those with OUD and without evidence of MOUD before admission when compared with propensity-matched admissions which did not receive inpatient MOUD.
OBJECTIVE: To determine the association between inpatient MOUD and the rate of PDD among patients without evidence of MOUD treatment prior to hospitalization.
DESIGN: Retrospective study comparing admissions receiving inpatient MOUD and propensity score-matched control admissions who did not receive MOUD.
SUBJECTS: Two thousand seven hundred seventy-one admissions with a diagnosis of OUD and without evidence of prior MOUD treatment were compared to 2771 propensity-matched admissions.
INTERVENTION: Provision of inpatient MOUD, either buprenorphine or methadone during admission.
MAIN MEASURES: Primary outcome was patient-directed discharge. Secondary outcomes were buprenorphine prescription at discharge, buprenorphine prescription within 60 days of discharge, admission into an outpatient methadone program within 30 days of discharge, 30-day readmission, and 30-day post-discharge ED visit.
KEY RESULTS: Among 5542 admissions with OUD and no evidence of MOUD prior to admission, those that received inpatient MOUD were significantly less likely to have a PDD (11.9% vs 14.4%; OR 0.80 [CI 0.67-0.96]) and significantly more likely to receive a discharge prescription for buprenorphine (8.6% vs 1.2%; OR 8.04 [CI 5.52-11.71]) and another buprenorphine prescription within 60 days of discharge (5.5% vs 1.1%; OR 5.09 [CI 3.35-7.74]), compared with control admissions who did not receive MOUD. Inpatient MOUD was not significantly associated with admission into an outpatient methadone program within 30 days, 30-day readmission, and 30-day post-discharge ED visit.
CONCLUSIONS: Receipt of inpatient MOUD was associated with a statistically significant reduction in PDD among those with OUD and without evidence of MOUD before admission when compared with propensity-matched admissions which did not receive inpatient MOUD.