A Hospital-Based Intervention to Improve Access to Buprenorphine for Patients with Opioid Use Disorder.

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Tác giả: Matthew Fine, Michael Herscher, Leeza Hirt Wilner, Trevor G Lee, Cameron K Ormiston, Linda Wang

Ngôn ngữ: eng

Ký hiệu phân loại:

Thông tin xuất bản: United States : Substance use & addiction journal , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 700125

 BACKGROUND: Opioid use disorder (OUD) is often under-addressed in hospitalized patients. In the absence of formal addiction consult services, volunteer physician-led models can increase access to inpatient OUD treatment. This paper describes a novel, volunteer physician-led interprofessional approach to identifying patients with OUD, initiating buprenorphine, and linking to office-based opioid treatment. METHODS: The intervention took place from April 2018 to August 2020 at a large, urban, tertiary care center and teaching hospital in New York, NY that does not have an addiction consult service. Hospitalized patients with OUD were identified by provider-driven referrals or an automated daily patient list generated by a bioinformatics search algorithm. Eligible patients with OUD were started on buprenorphine during their hospitalization and linked to primary care-based buprenorphine treatment. Patients were followed longitudinally via chart review to assess follow-up clinic rates at >
 30 days, >
 60 days, >
 90 days, >
 6 months, >
 12 months, and >
 24 months after discharge. RESULTS: Over a 2-year period, 178 patients were evaluated, 88 were eligible for inpatient buprenorphine, and 47 were started on buprenorphine while hospitalized. Sixty-seven patients were referred to a post-discharge visit at a primary care practice, 29 (43%) of whom attended an appointment at least 30 days after discharge. Of these, 22 (76%) returned at >
 60 days and 20 (69%) at 6 months. At the 1-year time point, 16 of a possible 17 patients (94%) and 15 of a possible 16 patients (94%) were still engaged in care at 2 years. CONCLUSION: This intervention represents a proof of principle, adaptable model for identifying patients with OUD and engaging patients in primary care-based buprenorphine treatment. Limitations to consider include the sustainability of a volunteer-based initiative and that retention rates for 1 to 2 years post-discharge may be more indicative of the strengths of office-based opioid treatment itself as opposed to in-hospital engagement and the intervention.
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