Bridging the Gap: Can Group Interventions Assist Addiction Consult Services in Providing Integrated, Comprehensive Healthcare for Patients Hospitalized for Opioid-Related Infections?

Background: Addiction Consult Services (ACS) have become an emergent clinical intervention for persons with substance use disorders (SUD) requiring hospital-based care. However, there have been few recent evaluations of the evidence for the effectiveness of ACS on SUD outcomes.Objective: We aimed to assess the effectiveness of ACS for persons with SUD on a range of SUD-related outcomes.Methods: We systematically reviewed peer-reviewed scientific literature measuring ACS outcomes. We searched 5 electronic sources (PubMed, MEDLINE, CINAHL, Cochrane, and EMBASE) from database inception through April 2021 and hand-searched article bibliographies for additional records. In addition, we considered any interventional or observational study design presenting original data and appraised study quality with the Joanna Briggs Institute checklist. Assessed outcomes included pharmacotherapy initiation in-hospital and postdischarge, retention in addiction treatment, length of hospital stay, 30-day readmissions, deaths, and patientdirected discharges. Finally, we conducted a narrative synthesis due to study design and outcome measurement heterogeneity.Results: From the initial pool of 1057 records, 26 studies (n = 12,823 participants; 60% male; mean age: 41 y) met review inclusion criteria. Most ACS provided pharmacotherapy, usually medications for opioid use disorder; add-on services varied, with some also providing psychotherapy (69%), discharge planning services (23%), and infectious disease consultation and treatment (19%). Overall, 7 studies (27%) observed positive impacts of ACS compared with control interventions on postdischarge engagement in addiction treatment and reduced addiction severity. Four studies (15%) reported no significant impacts of ACS versus control interventions on postdischarge care utilization or injection drug use frequency. The remaining 15 studies (58%) described the uptake of ACS-delivered treatments by hospital-based samples of patients with SUD but did not compare against a control condition.

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“…The included studies were published across >2 decades, spanning 1994 through 2022 (Table 1). 23,27,40–63 …”

Section: Resultsmentioning

confidence: 99%

The Effectiveness of Inpatient Addiction Consult Services: A Systematic Review and Narrative Synthesis

Bahji

Brothers

Mauer-Vakil

et al. 2023

Canadian Journal of Addiction

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“…Reports with multiple ACS sites [21][22][23][24][25] Boston Medical Center [26][27][28][29][30][31] Massachusetts General Hospital 14,[32][33][34][35] New York City Hospital + Health Systems 36 Oregon Health & Science University 7,8,10,11,12,13,15,[37][38][39][40][41][42] Rush (Chicago) SUIT [43][44][45] University of California San Francisco 46 University of Colorado 47 University of Maryland [48][49][50] Yale University 51 Unspecified site 52,53 Allegheny Health Network 54 ✓…”

Section: Psychiatry Consult Liaison Servicementioning

confidence: 99%

A Taxonomy of Hospital-Based Addiction Care Models: a Scoping Review and Key Informant Interviews

et al. 2022

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BACKGROUND: There is pressing need to improve hospital-based addiction care. Various models for integrating substance use disorder care into hospital settings exist, but there is no framework for describing, selecting, or comparing models. We sought to fill that gap by constructing a taxonomy of hospital-based addiction care models based on scoping literature review and key informant interviews. METHODS: Methods included a scoping review of the literature on US hospital-based addiction care models and interventions for adults, published between January 2000 and July 2021. We conducted semi-structured interviews with 15 key informants experienced in leading, implementing, evaluating, andpracticing hospital-based addiction care to explore model characteristics, including their perceived strengths, limitations, and implementation considerations. We synthesized findings from the literature review and interviews to construct a taxonomy of model types. RESULTS: Searches identified 2,849 unique abstracts. Of these, we reviewed 280 full text articles, of which 76 were included in the final review. We added 8 references from reference lists and informant interviews, and 4 gray literature sources. We identified six distinct hospitalbased addiction care models. Those classified as addiction consult models include (1) interprofessional addiction consult services, (2) psychiatry consult liaison services, and (3) individual consultant models. Those classified as practice-based models, wherein general hospital staff integrate addiction care into usual practice, include (4) hospital-based opioid treatment and (5) hospital-based alcohol treatment. The final type was (6) communitybased in-reach, wherein community providers deliver care. Models vary in their target patient population, staffing, and core clinical and systems change activities. Limitations include that some models have overlapping characteristics and variable ways of delivering core components. DISCUSSION: A taxonomy provides hospital clinicians and administrators, researchers, and policy-makers with a framework to describe, compare, and select models for implementing hospital-based addiction care and measure outcomes.

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The Impact of Addictions Management Following Cardiac Surgery on People Who Inject Drugs and Have Infective Endocarditis

Greene,

Sandila,

Pryor

et al. 2024

CJC Open

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Bridging the Gap: Can Group Interventions Assist Addiction Consult Services in Providing Integrated, Comprehensive Healthcare for Patients Hospitalized for Opioid-Related Infections?

Cited by 5 publications

References 12 publications

The Effectiveness of Inpatient Addiction Consult Services: A Systematic Review and Narrative Synthesis

The Effectiveness of Inpatient Addiction Consult Services: A Systematic Review and Narrative Synthesis

A Taxonomy of Hospital-Based Addiction Care Models: a Scoping Review and Key Informant Interviews

The Impact of Addictions Management Following Cardiac Surgery on People Who Inject Drugs and Have Infective Endocarditis

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