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35th AM (2025) - Poster Session
Dependence Severity as a Predictor of Outcomes in ...
Dependence Severity as a Predictor of Outcomes in Hospitalized Patients with Opioid Use Disorder
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Pdf Summary
This retrospective cohort study at Temple University Hospital examined how opioid dependence severity affects outcomes and the safety/effectiveness of inpatient interventions for hospitalized patients with opioid use disorder (OUD) and injection-related infections. The study included 435 adults with injection-related OUD and positive blood cultures between March 2022 and March 2024, excluding patients on IV opioids, patient-controlled analgesia, ketamine, or those deceased. Data analysis used multivariable logistic regression, chi-square, and t-tests.<br /><br />Key findings showed that addiction medicine consults provided the greatest benefit to patients at both ends of the opioid dependence severity spectrum, reducing patient-directed discharges (PDD) and early readmissions. Buprenorphine microinduction was protective regardless of dependence severity, demonstrating safety and efficacy as a treatment initiation method. Opioid agonist therapy (OAT) served as a safe, though not statistically significant, adjunct in aiding transition to medication for opioid use disorder (MOUD) particularly in patients with low dependence severity.<br /><br />The study highlights the lack of standardized inpatient guidelines for OUD management and identifies dependence severity as a critical factor modifying treatment effectiveness. Addiction medicine specialist involvement was shown to be essential in optimizing care, improving treatment retention, and decreasing adverse outcomes such as early discharges and readmissions. These findings support incorporating severity assessments into tailored inpatient treatment plans for OUD, emphasizing the role of addiction medicine expertise and the safety of buprenorphine microinduction across all patient groups. This approach could improve hospital outcomes and facilitate more effective transitions to outpatient OUD care.
Keywords
opioid use disorder
injection-related infections
opioid dependence severity
addiction medicine consults
patient-directed discharges
early readmissions
buprenorphine microinduction
opioid agonist therapy
medication for opioid use disorder
inpatient treatment guidelines
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