Effect of initiation of medications for opioid use disorder on hospitalization outcomes for endocarditis and osteomyelitis in a large private hospital system in the United States, 2014-18
| Autor: | Rebecca Nosal, Tyler S. Bartholomew, Young Jo, Christian Vandever, Clara Alvarez, Angela Vittori, Hansel E. Tookes, Leopoldo Cordova Md |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty 030508 substance abuse Medicine (miscellaneous) Article Hospitals Private 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Opiate Substitution Treatment Endocarditis Humans 030212 general & internal medicine Retrospective Studies business.industry Osteomyelitis Retrospective cohort study Opioid use disorder medicine.disease Opioid-Related Disorders United States Buprenorphine Hospitalization Psychiatry and Mental health Infective endocarditis Diagnosis code 0305 other medical science business medicine.drug Methadone |
| Zdroj: | Addiction |
| ISSN: | 1360-0443 |
| Popis: | BACKGROUND AND AIMS Opioid use disorder (OUD) has led to not only increases in overdose deaths, but also increases in endocarditis and osteomyelitis secondary to injection drug use (IDU). We studied the association between initiation of medications for opioid use disorder (MOUD) and treatment outcomes for people with infectious sequelae of IDU and OUD. DESIGN AND SETTING This is a retrospective cohort study reviewing encounters at 143 HCA Healthcare hospitals across 21 states of the United States from 2014 to 2018. PARTICIPANTS Adults aged 18-65 with the ICD diagnosis code for OUD and endocarditis or osteomyelitis (n = 1407). MEASUREMENTS Main exposure was the initiation of MOUD, defined as either methadone or buprenorphine at any dosage started during hospitalization. Primary outcomes were defined as patient-directed discharge (PDD), 30-day re-admission and days of intravenous antibiotic treatment. Covariates included biological sex, age, ethnicity, other co-occurring substance use disorders, and insurance status. FINDINGS MOUD was initiated among 269 (19.1%) patients during hospitalization. Initiation of MOUD was not associated with decreased odds of PDD. Initiation of MOUD did not impact 30-day re-admission. Patients who received MOUD, on average, had 5.7 additional days of gold-standard intravenous antibiotic treatment compared with those who did not [β = 5.678, 95% confidence interval (CI) = 3.563, 7.794), P |
| Databáze: | OpenAIRE |
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