Article Impact Level: HIGH Data Quality: STRONG Summary of JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2024.3422 Dr. Jennifer McNeely et al.
Points
- The study examined the effectiveness of interprofessional hospital addiction consultation services in enhancing MOUD treatment initiation and engagement post-discharge.
- Conducted across six public hospitals in New York, the study included 2,315 adults with opioid use disorder identified through Medicaid claims data from October 2017 to January 2021.
- Patients receiving the addiction consultation service had significantly higher odds of initiating MOUD (7.96 times) and engaging in MOUD treatment for 30 days (6.90 times) compared to usual care.
- During the intervention, 11.0% of patients initiated MOUD in the CATCH program versus 6.7% in usual care, and engagement rates were 7.4% versus 5.3%, respectively.
- Despite improvements, overall MOUD initiation and engagement rates remained relatively low, indicating the need for further enhancement of hospital-based and community-based addiction treatment services.
Summary
In a substantial study examining the effectiveness of interprofessional hospital addiction consultation services, researchers sought to determine if such services enhance the initiation and engagement of medication for opioid use disorder (MOUD) treatment following hospital discharge. Conducted across six public hospitals in New York, New York, the study included 2,315 adults with opioid use disorder identified through Medicaid claims data between October 2017 and January 2021. This pragmatic stepped-wedge cluster randomized trial assessed the impact of the intervention compared to usual care (TAU), focusing on MOUD treatment within 14 days of discharge and engagement over the following 30 days.
Results indicated a marked increase in MOUD initiation and engagement among patients who received the addiction consultation service. Specifically, during the intervention period, the odds of initiating MOUD were 7.96 times higher (log-odds ratio, 2.07; 95% credible interval, 0.51-4.00), and the odds of engaging in MOUD treatment for 30 days were 6.90 times higher (log-odds ratio, 1.93; 95% credible interval, 0.09-4.18) compared to those receiving usual care. The intervention resulted in 11.0% of patients initiating MOUD in the Consult for Addiction Treatment and Care in Hospitals (CATCH) program versus 6.7% in TAU, and engagement rates were 7.4% versus 5.3%, respectively.
The study underscores the potential of interprofessional addiction consultation services to significantly boost MOUD initiation and engagement among hospitalized patients with opioid use disorder. However, despite these improvements, the overall rates of MOUD initiation and engagement remained relatively low, highlighting the need for further enhancement of hospital- and community-based services to address the treatment needs effectively. This trial demonstrates the crucial role that hospital interventions can play in bridging gaps in addiction treatment during critical transition periods for patients.
Link to the article: https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2821706
References McNeely, J., Wang, S. S., Rostam Abadi, Y., Barron, C., Billings, J., Tarpey, T., Fernando, J., Appleton, N., Fawole, A., Mazumdar, M., Weinstein, Z. M., Kalyanaraman Marcello, R., Dolle, J., Cooke, C., Siddiqui, S., & King, C. (2024). Addiction Consultation Services for Opioid Use Disorder Treatment Initiation and Engagement: A Randomized Clinical Trial. JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2024.3422
