Patients with opioid use disorders who were hospitalized with an infection requiring prolonged antimicrobial therapy, and who received an addiction medicine consultation, had superior outcomes compared with those who did not receive the consultation, according to findings published in Clinical Infectious Diseases.
Individuals who inject drugs are often ineligible to receive outpatient parenteral antimicrobial therapy and have to undergo treatment in an inpatient setting. These prolonged periods of hospitalization can be challenging, as opioid cravings and withdrawal prompt many patients to leave the hospital before they have completed treatment. This study examined whether an inpatient consultation with an addiction medicine specialist improved outcomes and lowered the readmission rate for patients hospitalized with severe infectious complications of opioid use disorders.
The researchers performed a retrospective chart review of patients treated at an academic, tertiary care center, from January 2016 to January 2018; 125 participants met the inclusion criteria. Of this group, 38 (30.4%) received an addiction medicine consultation. An addiction medicine consultation was associated with a significantly greater rate of completing antimicrobial therapy: 30 (78.9%) vs 35 (40.2%) (odds ratio [OR], 5.57, 95% CI, 2.25-13.07). Discharges against medical advice were also significantly lower [6 (15.8%) vs 43 (49.4%); OR 0.19; 95% CI, 0.08-0.48]. Patients who received a consultation were also less likely to be readmitted within 90 days of discharge (subdistribution hazard ratio, 0.378; 95% CI, 0.21-0.69).
“These findings underscore the importance of addressing addiction issues in patients hospitalized with infectious complications associated with [opioid use disorders],” wrote the researchers.
Marks LR, Munigala S, Warren DK, Liang SY, Schwarz ES, Durkin MJ. Addiction medicine consultations reduce readmission rates for patients with serious infections from opioid use disorder [published October 23, 2018]. Clin Infect Dis. doi:10.1093/cid/ciy924