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35th AM (2025) - Poster Session
Impact of addiction consult services on one-year m ...
Impact of addiction consult services on one-year mortality and acute care utilization among inpatients with OUD
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Pdf Summary
This study evaluated the effectiveness of the Consult for Addiction Treatment and Care in Hospitals (CATCH) program—a multidisciplinary addiction consult service implemented across six New York City public hospitals—to improve care for inpatients with opioid use disorder (OUD). Conducted as a pragmatic stepped-wedge cluster randomized clinical trial from October 2017 to January 2021, the research included 1,355 adult Medicaid patients hospitalized with OUD or opioid poisoning who had not received medications for opioid use disorder (MOUD) in the prior 30 days.<br /><br />The CATCH program featured teams composed of medical providers, social workers or addiction counselors, and peer counselors working collaboratively to assess patients, provide treatment recommendations (including MOUD), deliver motivational counseling, and facilitate linkage to post-discharge addiction treatment and harm reduction services.<br /><br />Main outcomes measured one year post-discharge included acute care utilization (hospitalizations and emergency department [ED] visits) and mortality (all-cause, overdose, and opioid-involved overdose deaths). Statistical analyses adjusted for demographic and clinical variables and accounted for hospital clustering.<br /><br />Results showed that while CATCH did not significantly reduce hospitalizations or mortality rates compared to treatment as usual (TAU), it was associated with a statistically significant 21% reduction in post-discharge ED visits (incidence rate ratio 0.79, p=0.001). Mortality rates remained high across groups, with 8.3% all-cause deaths, 2.5% overdose deaths, and 2.1% opioid-involved overdose deaths within one year post-discharge.<br /><br />The study highlights that hospital-based addiction consult services like CATCH can effectively reduce emergency care utilization among patients with OUD, suggesting these programs serve as important intervention touchpoints. However, persistent high rates of acute care use and mortality underscore the need for broader, integrated strategies addressing the complex medical, behavioral, and social needs of this vulnerable population. Funded by NIH/NIDA, this trial provides robust evidence supporting hospital addiction consult services as a component of comprehensive OUD care.
Keywords
CATCH program
opioid use disorder
addiction consult service
hospital-based intervention
medications for opioid use disorder (MOUD)
emergency department visits reduction
stepped-wedge cluster randomized trial
New York City public hospitals
post-discharge care linkage
opioid overdose mortality
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