Role of Addiction Medicine Consultation Service in a Community Hospital: Evaluation of the Novel Service.

Abstract

Objectives: Fewer than 2500 physicians nationwide are certified in addiction medicine. Inpatient addiction hospitalist services have been shown to improve patient outcomes, but their capabilities and impact are underexplored in community hospitals. This study evaluates the role of an addiction medicine hospitalist service in enhancing patient outcomes in two community-based hospitals.

Methods: A retrospective chart review was conducted on patients who received care from addiction medicine service in two hospitals. The data were collected within the first 120 days of the establishment of service. The reason for consultation, substances used, types of management, impact on transition of care, readmissions and length of stay were evaluated.

Results: 152 patients were seen by the addiction medicine service during the study period. Majority of consultations came from internal medicine followed by general surgery, family medicine, burns and maternity. Ongoing substance use accounted for 47.7 % of consultations, 31.8 % for managing withdrawal, and 21.9 % for managing overdose and toxicity. Medications for alcohol use disorder were started in 87.5 % of cases and opioid use disorder in 96 %. Buprenorphine was the most commonly initiated medication for opioid use disorder and naltrexone for alcohol use disorder. In 14.7 % of cases, the service made a positive impact on length of stay. The readmission rate in these patients was 8.4 % as compared to 13 % for all the patients admitted to the hospital during the study period.

Conclusions: Addiction medicine hospitalist service can offer quality care to a wide variety of SUDs in a community hospital setting and supports multiple services.