Initiation of medication for opioid use disorder across a health system: A retrospective analysis of patient characteristics and inpatient outcomes

doi:10.1016/j.dadr.2022.100114

. 2022 Nov 12:5:100114.

doi: 10.1016/j.dadr.2022.100114. eCollection 2022 Dec.

Initiation of medication for opioid use disorder across a health system: A retrospective analysis of patient characteristics and inpatient outcomes

Brian P O'Rourke¹, Tory H Hogan¹, Julie Teater², Martin Fried³, Margaret Williams⁴, Alison Miller⁵, Aaron D Clark⁶, Phuong Huynh⁶, Emily Kauffman^{3

7}, Jennifer L Hefner^{1

6}

Affiliations

¹ The Division of Health Services Management and Policy, College of Public Health, The Ohio State University, 1841 Neil Ave Rm 250, Columbus, OH 43210, USA.
² The Department of Psychiatry and Behavioral Health, College of Medicine, The Ohio State University, 370 W. 9th Avenue, Columbus, OH 43210, USA.
³ The Division of General Internal Medicine, College of Medicine, The Ohio State University, 370 W. 9th Avenue, Columbus, OH 43210, USA.
⁴ The Division of Hospital Medicine, College of Medicine, The Ohio State University, 370 W. 9th Avenue, Columbus, OH 43210, USA.
⁵ Neurological Institute, The Ohio State University Wexner Medical Center, 410 W. 10th Ave, Columbus, OH 43210, USA.
⁶ The Department of Family and Community Medicine, College of Medicine, The Ohio State University, 370 W. 9th Avenue, Columbus, OH 43210, USA.
⁷ Department of Emergency Medicine, College of Medicine, The Ohio State University, 370 W. 9th Avenue, Columbus, OH 43210, USA.

PMID: 36844164
PMCID: PMC9948916
DOI: 10.1016/j.dadr.2022.100114

Initiation of medication for opioid use disorder across a health system: A retrospective analysis of patient characteristics and inpatient outcomes

Brian P O'Rourke et al. Drug Alcohol Depend Rep. 2022.

. 2022 Nov 12:5:100114.

doi: 10.1016/j.dadr.2022.100114. eCollection 2022 Dec.

Authors

Brian P O'Rourke¹, Tory H Hogan¹, Julie Teater², Martin Fried³, Margaret Williams⁴, Alison Miller⁵, Aaron D Clark⁶, Phuong Huynh⁶, Emily Kauffman^{3

7}, Jennifer L Hefner^{1

6}

Affiliations

¹ The Division of Health Services Management and Policy, College of Public Health, The Ohio State University, 1841 Neil Ave Rm 250, Columbus, OH 43210, USA.
² The Department of Psychiatry and Behavioral Health, College of Medicine, The Ohio State University, 370 W. 9th Avenue, Columbus, OH 43210, USA.
³ The Division of General Internal Medicine, College of Medicine, The Ohio State University, 370 W. 9th Avenue, Columbus, OH 43210, USA.
⁴ The Division of Hospital Medicine, College of Medicine, The Ohio State University, 370 W. 9th Avenue, Columbus, OH 43210, USA.
⁵ Neurological Institute, The Ohio State University Wexner Medical Center, 410 W. 10th Ave, Columbus, OH 43210, USA.
⁶ The Department of Family and Community Medicine, College of Medicine, The Ohio State University, 370 W. 9th Avenue, Columbus, OH 43210, USA.
⁷ Department of Emergency Medicine, College of Medicine, The Ohio State University, 370 W. 9th Avenue, Columbus, OH 43210, USA.

PMID: 36844164
PMCID: PMC9948916
DOI: 10.1016/j.dadr.2022.100114

Abstract

Objectives: Medication for opioid use disorder (MOUD) has gained significant momentum as an evidence-based intervention for treating opioid use disorder (OUD). The purpose of this study was to characterize MOUD initiations for buprenorphine and extended release (ER) naltrexone across all care sites at a major health system in the Midwest and determine whether MOUD initiation was associated with inpatient outcomes.

Methods: The study population comprised patients with OUD in the health system between 2018 and 2021. First, we described characteristics of all MOUD initiations for the study population within the health system. Second, we compared inpatient length of stay (LOS) and unplanned readmission rates between patients prescribed MOUD and patients not prescribed MOUD, including a pre-post comparison of patients prescribed MOUD before versus after initiation.

Results: The 3,831 patients receiving MOUD were mostly white, non-Hispanic and generally received buprenorphine over ER naltrexone. 65.5% of most recent initiations occurred in an inpatient setting. Compared to those not prescribed MOUD, inpatient encounters where patients received MOUD on or before the admission date were significantly less likely to be unplanned readmissions (13% vs. 20%, p < 0.001) and their LOS was 0.14 days shorter (p = 0.278). Among patients prescribed MOUD, there was a significant reduction in the readmission rate after initiation compared to before (13% vs. 22%, p < 0.001).

Conclusions: This study is the first to examine MOUD initiations for thousands of patients across multiple care sites in a health system, finding that receiving MOUD is associated with clinically meaningful reductions in readmission rates.

Keywords: Buprenorphine; Care coordination; Medication for opioid use disorder; Naltrexone; Opioid treatment programs.

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Conflict of interest statement

No conflict declared.

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Initiation of medication for opioid use disorder across a health system: A retrospective analysis of patient characteristics and inpatient outcomes

Affiliations

Initiation of medication for opioid use disorder across a health system: A retrospective analysis of patient characteristics and inpatient outcomes

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Abstract

Conflict of interest statement

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Abstract

Conflict of interest statement

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