阿片类药物或酒精使用障碍的成瘾咨询和药物治疗对再入院的影响

IF 4.2 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Journal of General Internal Medicine Pub Date : 2025-09-01 Epub Date: 2025-01-03 DOI:10.1007/s11606-024-09301-9

Eugene Lambert, Susan Regan, Sarah E Wakeman

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引用次数: 0

摘要

背景：物质使用障碍（SUD）患者经常住院和再入院。住院是开始治疗的机会，包括治疗酒精（MAUD）和阿片类药物使用障碍（MOUD）的药物。成瘾咨询小组是增加医院SUD治疗的一种模式。方法：回顾性分析一家拥有强大成瘾咨询团队的学术医疗中心2019年至2023年的成人住院情况。我们在广义线性模型中评估了成瘾咨询与入院期间mod或MAUD接收的关系，以及成瘾咨询、mod或MAUD出院处方或mod或MAUD新开始与30天再入院率的关系。结果：10453例独特患者中有19697例SUD患者入院。成瘾咨询与入院期间较高的药物接收率相关（mod, 84% vs. 49%, p）结论：成瘾咨询与MAUD和mod接收增加以及30天再入院风险降低相关。MAUD起始和MAUD起始与再入院风险降低相关。

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The Impact of Addiction Consultation and Medication for Opioid or Alcohol Use Disorder on Hospital Readmission.

Background: Patients with substance use disorder (SUD) are frequently hospitalized and readmitted. Hospitalization is an opportunity for treatment initiation, including medications for alcohol (MAUD) and opioid use disorder (MOUD). Addiction consult teams are one model for increasing hospital-based SUD treatment.

Methods: Retrospective analysis examining adult hospitalizations from 2019 to 2023 at an academic medical center with a robust addiction consult team. We assessed the association of addiction consultation with MOUD or MAUD receipt during admission, and the association of addiction consultation, MOUD or MAUD discharge prescription, or MOUD or MAUD new initiation with 30-day readmission rates in generalized linear models.

Results: There were 19,697 admissions for patients with SUD among 10,453 unique patients. Addiction consultation was associated with higher rates of medication receipt during admission (MOUD, 84% vs. 49%, p < 0.001; MAUD, 33.4% vs. 6.0%, p < 0.001) For patients with OUD, MOUD discharge prescription rates doubled among those seen by the consult team (RR, 2.29; 95% CI, (2.02-2.60). For those with AUD, MAUD discharge prescription rates increased several-fold among those seen by the consult team (RR, 9.48; 95% CI, 8.05-11.16). Addiction consultation was associated with reduced risk of readmission (aRR, 0.82; 95% CI, 0.75-0.89). For AUD, discharge MAUD was associated with reduced risk of readmission (aRR, 0.84; 95% CI, 0.72-0.99) as was new MAUD initiation (aRR, 0.78; 95% CI, 0.629-0.977). For OUD, addiction consultation was associated with a reduced risk of readmission (aRR, 0.77; 95% CI, 0.68-0.87) as was newly initiating MOUD and prescribing it at discharge (aRR, 0.46; 95% CI, 0.33-0.46).

Conclusion: Addiction consultation is associated with increased MAUD and MOUD receipt and decreased risk of 30-day readmission. MOUD initiation and MAUD initiation are associated with reduced risk of readmission.

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来源期刊

Journal of General Internal Medicine 医学-医学：内科

CiteScore

7.70

自引率

5.30%

发文量

749

审稿时长

3-6 weeks

期刊介绍： The Journal of General Internal Medicine is the official journal of the Society of General Internal Medicine. It promotes improved patient care, research, and education in primary care, general internal medicine, and hospital medicine. Its articles focus on topics such as clinical medicine, epidemiology, prevention, health care delivery, curriculum development, and numerous other non-traditional themes, in addition to classic clinical research on problems in internal medicine.