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Abstract
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Background
Hospitalized patients with opioid use disorder (OUD) present unique challenges and opportunities for inpatient medical teams. Having the ability to initiate medications for opioid use disorder (MOUD), and linkage patients to outpatient treatment and providers are key to improve inpatient care of patients with OUD.
Objective
This study aimed to describe the process taken by a multi-disciplinary work group to improve the acute care management of patients with OUD.
Practice Description
In 2018, we identified that inpatient care teams at the University of Chicago Medicine (UCM) lacked a standardized approach to the management of hospitalized patients with OUD and that the care typically did not include evidence-based therapies. Herein, we describe the process taken to develop the OUD workgroup and the work completed by the workgroup.
Practice innovation
The OUD workgroup spearheaded the development of an OUD consult service, formulary revisions, education for health care workers (inpatient nurse training, X-waiver training for prescribers), and outpatient partnerships. Pharmacy-led initiatives included formulary management, electronic medication orders, naloxone co-prescribing decision support, and MOUD education.
Evaluation methods
The OUD consult service was granted an IRB-exemption for quality improvement analysis through UCM. A data analytics dashboard was built to track consult service volumes and outcomes.
Results
From July 2020-April 2021 296 OUD consults occurred. In total, 103 (35%) consult patients received and were discharged with buprenorphine. An additional 118 (40%) were managed with methadone and linked to outpatient care. An increase in naloxone dispensing at discharge, rate over 65%, which does not included patients who opted out or were discharge to a facility.
Conclusion
The ongoing opioid use disorder epidemic presents a need for the development of services to improve management of patients with OUD in the acute care setting. The OUD workgroup has improved the management of patients admitted with OUD. Pharmacy-based initiatives are key to the development of safe and effective management of OUD in hospitalized patients.
Language: en |