O'Rourke Brian P, Hogan Tory H, Teater Julie, Fried Martin, Williams Margaret, Miller Alison, Clark Aaron D, Huynh Phuong, Kauffman Emily, Hefner Jennifer L
The Division of Health Services Management and Policy, College of Public Health, The Ohio State University, 1841 Neil Ave Rm 250, Columbus, OH 43210, USA.
The Department of Psychiatry and Behavioral Health, College of Medicine, The Ohio State University, 370 W. 9th Avenue, Columbus, OH 43210, USA.
Drug Alcohol Depend Rep. 2022 Nov 12;5:100114. doi: 10.1016/j.dadr.2022.100114. eCollection 2022 Dec.
Medication for opioid use disorder (MOUD) has gained significant momentum as an evidence-based intervention for treating opioid use disorder (OUD). The purpose of this study was to characterize MOUD initiations for buprenorphine and extended release (ER) naltrexone across all care sites at a major health system in the Midwest and determine whether MOUD initiation was associated with inpatient outcomes.
The study population comprised patients with OUD in the health system between 2018 and 2021. First, we described characteristics of all MOUD initiations for the study population within the health system. Second, we compared inpatient length of stay (LOS) and unplanned readmission rates between patients prescribed MOUD and patients not prescribed MOUD, including a pre-post comparison of patients prescribed MOUD before versus after initiation.
The 3,831 patients receiving MOUD were mostly white, non-Hispanic and generally received buprenorphine over ER naltrexone. 65.5% of most recent initiations occurred in an inpatient setting. Compared to those not prescribed MOUD, inpatient encounters where patients received MOUD on or before the admission date were significantly less likely to be unplanned readmissions (13% vs. 20%, < 0.001) and their LOS was 0.14 days shorter ( = 0.278). Among patients prescribed MOUD, there was a significant reduction in the readmission rate after initiation compared to before (13% vs. 22%, < 0.001).
This study is the first to examine MOUD initiations for thousands of patients across multiple care sites in a health system, finding that receiving MOUD is associated with clinically meaningful reductions in readmission rates.
阿片类物质使用障碍药物治疗（MOUD）作为一种治疗阿片类物质使用障碍（OUD）的循证干预措施，已获得显著发展。本研究的目的是描述中西部一家大型医疗系统中所有医疗机构丁丙诺啡和缓释（ER）纳曲酮的MOUD起始情况，并确定MOUD起始是否与住院结局相关。
研究人群包括2018年至2021年该医疗系统中的OUD患者。首先，我们描述了该医疗系统内研究人群所有MOUD起始的特征。其次，我们比较了开具MOUD的患者和未开具MOUD的患者的住院时间（LOS）和非计划再入院率，包括对开具MOUD的患者起始前后的前后比较。
3831名接受MOUD治疗的患者大多为非西班牙裔白人，且一般接受丁丙诺啡而非ER纳曲酮治疗。最近一次起始的65.5%发生在住院环境中。与未开具MOUD的患者相比，在入院日期或之前接受MOUD的患者住院时非计划再入院的可能性显著降低（13%对20%，<0.001），且其住院时间短0.14天（=0.278）。在开具MOUD的患者中，起始后与起始前相比再入院率显著降低（13%对22%，<0.001）。
本研究首次在一个医疗系统中对多个医疗机构的数千名患者的MOUD起始情况进行了研究，发现接受MOUD与再入院率在临床上有意义的降低相关。
