SHM Converge Scientific Abstract ePoster Gallery-Association of Methadone Dose and Timing With Patient-Directed Discharge in Hospitalized Patients With Opioid Use Disorder

Association of Methadone Dose and Timing With Patient-Directed Discharge in Hospitalized Patients With Opioid Use Disorder

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This retrospective cohort study examined whether the timing and dose of methadone given to hospitalized adults with opioid use disorder (OUD) were associated with patient-directed discharge (PDD). The authors studied 325 patients at a single academic health center in the northeastern United States from July 2019 to June 2022. Eligible patients had OUD, were not already prescribed methadone before admission, and received methadone within 72 hours of emergency department presentation.<br /><br />The main exposure was cumulative methadone dose received by 24, 48, and 72 hours after initial evaluation. The primary outcome was PDD at 48, 72, or 96 hours, or at any point during hospitalization.<br /><br />Overall, 13.8% of patients had a PDD. In adjusted analyses, higher early methadone dosing was associated with lower odds of PDD. Specifically, for every 10 mg increase in methadone given in the first 24 hours, the odds of ever having a PDD decreased by 21% (adjusted OR 0.79, 95% CI 0.67–0.91). Similar but weaker associations were seen for cumulative dose at 48 and 72 hours. Some time-specific outcomes were also significant, including lower odds of PDD at 72 and 96 hours with higher 24-hour dosing.<br /><br />The findings suggest that earlier and higher methadone dosing may reduce the risk of patient-directed discharge among hospitalized patients with OUD. The authors conclude that more research is needed to determine safe and effective methadone dosing strategies for managing acute withdrawal in the hospital.

Asset Subtitle

William M. Garneau

Meta Tag

Author List Kenneth Feder, Megan Buresh, Rebecca Meredith, William M. Garneau

Category Research

Concept Methadone

Concept Patient-Directed Discharge

Concept Cumulative Dose

Concept Opioid Use Disorder

Concept Early Treatment

Distinguished Non-Finalist

Presenter Organization Johns Hopkins Hospital/Johns Hopkins University School of Medicine

Presenting Author William M. Garneau

Track Outcomes Research

Keywords

methadone

opioid use disorder

patient-directed discharge

hospitalized adults

retrospective cohort study

early dosing

cumulative dose

withdrawal management

adverse discharge

acute care

Methadone

Patient-Directed Discharge

Cumulative Dose

Opioid Use Disorder

Early Treatment