Landing in a hospital is a bad sign for the health journey of someone with an opioid use disorder (OUD). However, new research shows that in-hospital interventions can have substantial clinical payoffs when it comes to initiating medication for opioid use disorder (MOUD) after discharge.
Researchers at the New York University Grossman School of Medicine partnered with New York City Health + Hospitals to track the impact of the Consult for Addiction Treatment and Care in Hospitals (CATCH) program in 6 hospitals. In short, people hospitalized with an OUD were about eight times more likely to initiate MOUD and about seven times more likely to continue treatment 30 days after discharge.
The study tracked 2,315 patients who both received treatment during a time when interdisciplinary CATCH teams were in place at the hospitals and those that did not from October 2017 to January 2021. The teams had three members: an addiction physician or nurse practitioner (who led the group), a social worker or addiction counselor and a peer counselor.
“Addiction consult programs like CATCH have tremendous potential to reduce the negative consequences of untreated substance use disorder,” Dr. Jennifer McNeely, principal investigator of the study and associate professor at NYU Langone, said in a news release. “We have highly effective medications for treating opioid use disorder and preventing overdose, but far too few patients are receiving them.
“It is our hope that programs like CATCH will be replicated, reimbursed, and rolled out at hospitals across the country, to transform hospital care for patients with substance use disorder.”
The hospitals provided CATCH service at the request of the patient’s medical care team and provided it regardless of insurance coverage. The study population was limited to Medicaid enrollees with OUD. The teams made diagnoses at the bedside and provided recommendations for care, harm reduction, including take-home naloxone and peer support.
“A key function was to link patients to post-discharge community-based addiction treatment. If a treatment linkage could not be established before discharge, patients may be referred to short-term bridge clinics staffed by CATCH providers,” the research report states.
Despite the increased likelihood of treatment and retention, absolute rates of MOUD initiation and engagement remained relatively low. Those who received CATCH care initiated MOUD at a rate of 11%, compared to 7% for those who did not. Retention at six months was about 3%, compared to 2%.
“Hospitals have an important role to play in identifying and treating patients with SUD,” the study states. “Further efforts to improve and evaluate hospital-based and community-based service models that can improve rates of MOUD treatment and address the needs of patients who use substances other than opioids are still needed.”
