Impact of an addiction medicine consult service on medications for opioid use disorder initiation in hospitalized patients.

OBJECTIVE

The number of overdose deaths rose by 60 percent between 2019 and 2021. Medications for opioid use disorder (MOUD) have been associated with reduced overdoses and opioid-related hospitalizations. Hospital addiction medicine consult services (AMCSs) have been shown to reduce all-cause 90-day mortality post-discharge. This study aimed to expand on the impact of AMCS on the initiation of MOUD in inpatients. Design, setting, patients/participants, interventions, main outcome measure: This study is a retrospective, single site, multicenter, cohort study conducted at two sites. Utilizing International Classification of Diseases, Tenth Revision codes related to opioid use disorder (OUD), inpatients older than 18 years who were not already on MOUD were assessed at two separate hospitals during two time periods each. Site 1 initiated an AMCS in 2021, while site 2 had no AMCS. Data for each site for each period were assessed at baseline and post-ACMS initiation, and we compared the change in MOUD initiation rates between these periods at site 1 and site 2.

RESULTS

A total of 504 patients were assessed. The rate of MOUD initiation at site 1 was 8 percent (10/126) for the baseline and 21 percent (26/126) for the post-period (difference in proportions = 0.13; 95 percent confidence interval [CI] 0.04-0.21; p = 0.004). The rate of MOUD initiation at site 2 was 5 percent (6/126) for the preperiod and 6 percent (8/126) for the post-period (difference in proportions = 0.016; 95 percent CI -0.04-0.075; p = 0.582).

CONCLUSIONS

Availability of a hospital AMCS was associated with increased rates of MOUD initiation in inpatients with a history of OUD not on MOUD.