{"title":"Quantitative and qualitative outcomes associated with inpatient addiction consultation: a scoping review.","authors":"Laura Rodger, Jeremy Cygler, Andrew Pinto","doi":"10.1080/00952990.2024.2350696","DOIUrl":null,"url":null,"abstract":"<p><p><i>Background:</i> Rates of acute care use, including hospital admission and readmission, are high for people who misuse substances. Hospitalization provides a valuable opportunity for intervention, but addiction treatment is often not addressed in the inpatient setting. Addiction consult services are a novel intervention intended to change hospital practices.<i>Objectives:</i> Comprehensively summarize outcomes (quantitative and qualitative) associated with inpatient addiction consult services.<i>Methods:</i> English-language searches of: Medline, CINAHL, Embase, The Cochrane Database of Systematic Reviews, PubMed, PsychInfo and Google Scholar were conducted from 2000 to November 2022. Studies reporting outcomes associated with addiction specialist consultation in the hospital setting were included. Four independent reviewers screened abstracts, and three reviewers screened full-text articles.<i>Results:</i> A total of 1,113 results underwent title and abstract screening and 43 studies were included. Outcomes associated with addiction specialist consultation were heterogeneous. Quantitative clinical outcomes focused on pharmacotherapy, healthcare utilization, and outpatient follow-up. Consultation improved rates of pharmacotherapy use, but had inconsistent effects on health care use, and overall follow-up rates were low. Consultation was associated with reduced overdose rates and 90-day mortality. Additional outcomes related to medical learners' educational achievements and qualitative results described positive effects on trainees, healthcare providers, and patients seen by specialized consult services. Access to dedicated providers improved experiences in hospitals for both people who misuse substances and their healthcare providers.<i>Conclusion:</i> Addiction specialist consultations are related to several clinical metrics, but some outcomes (e.g. pharmacotherapy initiation) may be more amenable to intervention than others (healthcare utilization). Qualitative findings provide important context for quantitative clinical results.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"1-32"},"PeriodicalIF":2.7000,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Drug and Alcohol Abuse","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/00952990.2024.2350696","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHOLOGY, CLINICAL","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Rates of acute care use, including hospital admission and readmission, are high for people who misuse substances. Hospitalization provides a valuable opportunity for intervention, but addiction treatment is often not addressed in the inpatient setting. Addiction consult services are a novel intervention intended to change hospital practices.Objectives: Comprehensively summarize outcomes (quantitative and qualitative) associated with inpatient addiction consult services.Methods: English-language searches of: Medline, CINAHL, Embase, The Cochrane Database of Systematic Reviews, PubMed, PsychInfo and Google Scholar were conducted from 2000 to November 2022. Studies reporting outcomes associated with addiction specialist consultation in the hospital setting were included. Four independent reviewers screened abstracts, and three reviewers screened full-text articles.Results: A total of 1,113 results underwent title and abstract screening and 43 studies were included. Outcomes associated with addiction specialist consultation were heterogeneous. Quantitative clinical outcomes focused on pharmacotherapy, healthcare utilization, and outpatient follow-up. Consultation improved rates of pharmacotherapy use, but had inconsistent effects on health care use, and overall follow-up rates were low. Consultation was associated with reduced overdose rates and 90-day mortality. Additional outcomes related to medical learners' educational achievements and qualitative results described positive effects on trainees, healthcare providers, and patients seen by specialized consult services. Access to dedicated providers improved experiences in hospitals for both people who misuse substances and their healthcare providers.Conclusion: Addiction specialist consultations are related to several clinical metrics, but some outcomes (e.g. pharmacotherapy initiation) may be more amenable to intervention than others (healthcare utilization). Qualitative findings provide important context for quantitative clinical results.
期刊介绍：
The American Journal of Drug and Alcohol Abuse (AJDAA) is an international journal published six times per year and provides an important and stimulating venue for the exchange of ideas between the researchers working in diverse areas, including public policy, epidemiology, neurobiology, and the treatment of addictive disorders. AJDAA includes a wide range of translational research, covering preclinical and clinical aspects of the field. AJDAA covers these topics with focused data presentations and authoritative reviews of timely developments in our field. Manuscripts exploring addictions other than substance use disorders are encouraged. Reviews and Perspectives of emerging fields are given priority consideration.
Areas of particular interest include: public health policy; novel research methodologies; human and animal pharmacology; human translational studies, including neuroimaging; pharmacological and behavioral treatments; new modalities of care; molecular and family genetic studies; medicinal use of substances traditionally considered substances of abuse.
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