SHM Converge Scientific Abstract ePoster Gallery-Outcomes of a Hospitalist-Led Consult Service for Patients With Opioid Use Disorder

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This study evaluated COMET, a hospitalist-led consult service for patients with opioid use disorder (OUD) at Duke Hospital. Using retrospective electronic health record data, the investigators compared patients who received a COMET consult with both a historical pre-COMET control group and a concurrent control group from the same time period who did not receive COMET. Propensity score overlap weighting was used to reduce confounding, and regression/survival models assessed outcomes.<br /><br />COMET was associated with substantially higher inpatient and discharge treatment for OUD. Compared with controls, more COMET patients received medication for opioid use disorder (MOUD) during hospitalization (about 79% vs 30–43%), were discharged on buprenorphine (about 67% vs 17–28%), and received naloxone prescriptions at discharge (about 70% vs 36–45%). COMET patients also had a longer hospital length of stay.<br /><br />In terms of clinical outcomes, COMET was associated with lower 30-day mortality and lower 30-day readmission in some analyses. The mortality benefit was not clearly sustained at 90 days, and there was no meaningful association with 30-day emergency department visits or self-directed discharge.<br /><br />Overall, the findings suggest that a hospitalist-led addiction consult service can improve evidence-based OUD treatment during hospitalization and at discharge, and may reduce near-term mortality and readmissions. The authors note that COMET did not appear to affect self-directed discharge, identifying this as an area for future improvement. They conclude that expanding such consult services may help improve care for hospitalized patients with OUD.

Asset Subtitle

Dana C. Clifton

Meta Tag

Author List Alyssa Platt, Chuan Hong, Dana C. Clifton, Noel Ivey, Noppon P. Setji

Category Research

Concept Consult Service

Concept Opioid Use Disorder

Concept Medication for Opioid Use Disorder

Concept Retrospective Observational Cohort Study

Concept Propensity Score Overlap Weighting

Distinguished Non-Finalist

Presenter Organization Duke University Health System

Presenting Author Dana C. Clifton

Track Outcomes Research

Keywords

opioid use disorder

hospitalist-led consult service

COMET

medication for opioid use disorder

buprenorphine

naloxone prescription

propensity score weighting

retrospective electronic health record

mortality reduction

hospital readmission

Consult Service

Opioid Use Disorder

Medication for Opioid Use Disorder

Retrospective Observational Cohort Study

Propensity Score Overlap Weighting