Strategies to Link Patients Initiating Medications for Opioid Use Disorder in Acute Care Settings to Ongoing Care Following Discharge

To address the ongoing overdose crisis, acute care settings are developing programs to increase initiation of medications for opioid use disorder (MOUD). However, barriers remain to successfully linking patients to MOUD after hospital discharge. Researchers utilized a modified Delphi process to determine consensus among experts in addiction research, care transitions, and inpatient addiction clinical care on both the impact and feasibility of MOUD transition intervention strategies for acute care settings.

• Over three survey rounds, participants rated the impact and feasibility of 14 OUD care transition strategies identified in the literature. There were 71 participants invited; 45 completed the first round, representing 27 institutions from 14 US states and British Columbia, Canada.
• The original 14 strategies—plus eight additional items proposed by the participants—were deemed medium or high-impact and incorporated into the final taxonomy.
• Strategies with the highest impact and feasibility ratings included MOUD initiation during hospitalization, discussing community MOUD treatment options with patients, and providing a bridge buprenorphine prescription or medication to patients at, or prior to, discharge.

Comments: The 22 MOUD transition interventions identified in this study are a useful reference for both acute care and outpatient clinicians and researchers in developing and evaluating programmatic interventions to improve care for people with OUD. Strategies submitted by Delphi participants only underwent one round of voting, which may have negatively influenced impact and feasibility scores due to lack of a consensus-building round.

Ximena A. Levander, MD

Reference: Krawczyk N, Miller M, Englander H, et al. Toward a consensus on strategies to support opioid use disorder care transitions following hospitalization: a modified Delphi process. J Gen Intern Med. 2025;40(5):1048–1058.