Interprofessional Addiction Consultation Services Improved Receipt of Medications for Opioid Use Disorder Following Hospitalization

Hospitalization presents an opportunity to initiate medications for opioid use disorder (MOUD) among adults with OUD. This stepped-wedge cluster randomized clinical trial evaluated whether interprofessional addiction consultation services (ACS) implemented across six New York public hospitals increased MOUD initiation (in the 14 days following hospital discharge) and MOUD engagement (for the 30 days following initiation) among hospitalized adults with OUD, compared with usual care.

• Within 14 days of hospital discharge, MOUD initiation was 11 percent among patients who received ACS versus 7 percent among those who received usual care.
• Patients hospitalized during the ACS treatment period had 7.96 times higher odds of initiating MOUD, compared with those hospitalized in the usual care period.
• At 30 days following initiation, MOUD engagement was 7 percent among patients who received ACS versus 5 percent among those who received usual care; at six months, it was 3 percent versus 2 percent, respectively.

Comments: Hospital-based clinicians have an important role to play in identifying patients with OUD and offering and initiating MOUD. However, MOUD treatment initiation is just one element the OUD care cascade; the benefits of MOUD are realized with ongoing treatment engagement in the outpatient setting. Identifying ways to expand in-hospital OUD treatment provision and to improve community-based OUD services are urgently needed to support people with OUD. MOUD initation and treatment retention are both essential to reduce the morbidity and mortality associated with untreated OUD.

Susan L. Calcaterra, MD, MPH, MS

Reference: McNeely J, Wang SS, Rostam Abadi Y, et al. Addiction consultation services for opioid use disorder treatment initiation and engagement: a randomized clinical trial. JAMA Intern Med. 2024;184(9):1106–1115.