SHM Converge Scientific Abstract ePoster Gallery-Inpatient Medication for Opioid Use Disorder and Patient Directed Discharge

Pdf Summary

This retrospective propensity-score matched study examined hospital admissions for patients with opioid use disorder (OUD) to see whether receiving inpatient medications for OUD (MOUD)—methadone or buprenorphine—was linked to better outcomes. The researchers matched 507 admissions that received inpatient MOUD with 507 similar admissions that did not.<br /><br />The groups were well balanced in terms of age, sex, race/ethnicity, insurance, OUD type, comorbid substance use, liver disease, prior health care use, ICU admission, and addiction consult service involvement. Among the MOUD group, most patients received methadone, while fewer received buprenorphine or both.<br /><br />The main finding was that inpatient MOUD was associated with a lower rate of patient-directed discharge, meaning fewer patients left the hospital against medical advice or before the care team recommended discharge. Specifically, patient-directed discharge occurred in 9.1% of the MOUD group versus 14.8% of the control group. In adjusted analysis, the odds ratio was 0.57, indicating a significant protective association.<br /><br />A secondary benefit was a higher likelihood of receiving a buprenorphine prescription at discharge: 6.5% in the MOUD group versus 1.4% in controls. In contrast, inpatient MOUD was not associated with significant reductions in 30-day emergency department visits or 30-day readmissions.<br /><br />Subgroup analyses suggested the strongest benefit among patients who had previously received MOUD, those with comorbid substance use disorders, and those with Charlson comorbidity score of 2, while benefit was less clear in patients with liver disease or ICU admission.<br /><br />Overall, the study suggests that providing methadone or buprenorphine during hospitalization may help keep patients with OUD engaged in care and reduce patient-directed discharge.

Asset Subtitle

Sumeet Singh-Tan

Meta Tag

Author List Andrea Jakubowski, Jessica Pacifico, Julia Arnsten, Kristine Torres-Lockhart, Sumeet Singh-Tan, William N. Southern

Category Research

Concept Medication for Opioid Use Disorder

Concept Opioid Use Disorder

Concept Patient-Directed Discharge

Concept Methadone

Concept Buprenorphine

Distinguished Non-Finalist

Presenter Organization Albert Einstein College of Medicine, Montefiore Medical Center

Presenting Author Sumeet Singh-Tan

Track Outcomes Research

Keywords

opioid use disorder

inpatient MOUD

methadone

buprenorphine

patient-directed discharge

hospital admission

propensity-score matched study

addiction consult service

discharge prescription

retrospective study

Medication for Opioid Use Disorder

Opioid Use Disorder

Patient-Directed Discharge

Methadone

Buprenorphine