As part of a $5 million grant from the National Institutes of Health, researchers at Cedars Sinai Department of Psychiatry and Behavioral Neurosciences will lead a multi-site study into starting treatment for patients with opioid use disorder when they are hospitalized.
Researchers hope the study will improve care for hospitalized patients and get them into treatment quicker and more effectively.
Between 2002 and 2012, the researchers said, over 500,000 people were hospitalized with complications of opioid use. In these cases, however, doctors would often treat the acute condition that required hospitalization, and not the underlying opioid use disorder. Instead, patients were often given a list of referral options.
With this grant, researchers at Cedars-Sinai, the RAND Corporation, the University of New Mexico Hospital in Albuquerque, N.M., and Baystate Health in Springfield, Mass., will look into a new model of care that would identify patients with opioid use disorder and start them on treatment in the hospital while treating their more acute health issues. Afterward, treatment specialists would link them to aftercare programs in the community.
Using a consultative care team comprised of a care manager and a physician specializing in addiction treatment, the treatment will focus on guiding medical and surgical teams to incorporate evidence-based treatments for addictions into their patients’ treatment.
“Hospitalization represents a critical window of opportunity to identify underlying health problems or disparities, and initiate interventions to address them,” said Itai Danovitch, chair of the Cedars-Sinai Department of Psychiatry and Behavioral Neurosciences and co-principal investigator of this study. “Opioid use disorders are a very compelling example of this because once somebody is hospitalized for an overdose, their long-term risk of returning to the hospital is exceptionally high. Offering addiction treatment and getting them on the road to recovery has a profound impact on health, and also helps to reduce avoidable readmissions and health care costs. This is an opportunity to improve value for patients and improve efficiency for systems of care.”
The study is expected to begin this summer and focus on up to 414 patients. Patients will either receive a consultative team or receive standard care. An addiction physician will conduct an assessment on whether the patient is a candidate for medication-assisted treatment, and the care manager will develop an addiction-focused discharge plan with active follow-up care and post-discharge management. Researchers will evaluate the two methods to determine if the consultative mode is more effective in getting the patient into aftercare.
The study will also look at the model’s variability and context across the three sites to see how it can be scaled to fit other hospitals’ needs.
“The hope is that offering addiction care during the hospitalization will help us reach people who are suffering and disconnected, and help close the gap in treatment for this addressable disease,” said Danovitch. “Knowledge from this study could transform the way care is provided in hospitals for opioid use disorders, as well as other behavioral health conditions such as depression.”