NATIONAL HARBOR, Md. — Hospitalization provides a unique opportunity to screen, educate, support and treat patients with opioid use disorder, according to research presented at Hospital Medicine 2019.
In 2017, more than 70,000 patients died as a result of opioid overdose, according to the CDC, Richard Bottner, PA-C, hospitalist at Dell Seton Medical Center and assistant clinical professor at Dell Medical School at the University of Texas at Austin, told Healio Primary Care Today.
“Opioid use disorder is the epidemic of our time,” Christopher Moriates, MD, assistant dean for healthcare value at Dell Medical School at the University of Texas at Austin, told Healio Primary Care Today. “Deaths last year from opioids surpassed peak deaths from other prior health crises, such as the HIV epidemic.”
At some point, a majority of patients with opioid use disorder present to the hospital, Bottner said.
“Providing patients medication-assisted treatment with buprenorphine improves mortality and quality of life and reduces cost to the health care system,” he added.
However, lifesaving treatments like buprenorphine are not offered to most patients, according to Moriates.
Bottner, Moriates and colleagues created a multidisciplinary, hospital medicine-led service, known as the “B-Team,” to offer patients with opioid use disorder counseling, support and treatment with buprenorphine during hospitalizations.
The researchers developed an inpatient buprenorphine induction protocol based on a literature review of the current hospital-based medication-assisted treatment programs.
“The B-Team is partnered with a clinic in the community that provides a seamless handoff to ongoing care for the often chronic and relapsing condition of opioid use disorder,” Moriates said.
The primary hospital referred patients to the B-team program. Patients were screened by a social worker. A clinical provider would then initiate therapy in qualified patients in conjunction with the primary team, ensuring a relationship with the outpatient clinic.
The researchers performed 30 consultations in 8 weeks. Overall, one-third of the patients were linked to outpatient therapy, most of whom continued therapy after 3 months.
“Hospitalization is a critical opportunity to intervene for patients with opioid use disorder — it is a ‘reachable moment,’” Moriates said. “Hospitalists can make a big difference in these situations.” – by Alaina Tedesco
Bottner R, et al. The B-Team (buprenorphine): Medication-assisted treatment for patients with opioid use disorder in the hospital. Presented at: Hospital Medicine 2019. March 25-27; National Harbor, Md.
Disclosure: Moriates reports no relevant financial disclosures.