OUD MEETS: A novel program to increase initiation of medications for opioid use disorder and improve outcomes for hospitalized patients being discharged to skilled nursing facilities

• Published in: Journal of substance abuse treatment 2022-12, Vol.143, p.108895, Article 108895
• Main Authors: Tassey, Theresa E., Ott, Geoffrey E., Alvanzo, Anika A.H., Peirce, Jessica M., Antoine, Denis, Buresh, Megan E.
• Format: Article
• Language: English
• Subjects: Access; Acute services; Analgesics, Opioid - therapeutic use; Buprenorphine; Buprenorphine - therapeutic use; Clinical outcomes; Discharge; Drugs; Feasibility; Hospitalization; Hospitalized; Humans; Medical treatment; Medications for opioid use disorder; Methadone; Methadone - therapeutic use; Narcotics; Nursing; Opiate Substitution Treatment; Opioid use disorder; Opioid-Related Disorders - drug therapy; Opioids; Patient Discharge; Patient-directed discharge; Patients; Policy making; Skilled Nursing Facilities; Skilled nursing facility; Substance use disorder; Transitions of care; Treatment programs
• ISSN: 0740-5472; 1873-6483
• DOI: 10.1016/j.jsat.2022.108895

Rates of hospitalizations from medical complications of opioid use disorder (OUD) are rising and many of these patients require post–acute care at skilled nursing facilities (SNFs). However, access to medication for OUD (MOUD) at SNFs remains low and patients with OUD have high rates of patient-directed discharge (PDD) and hospital readmissions. Opioid Use Disorder Medical Patient Engagement, Enrollment in treatment and Transitional Supports (OUD MEETS) program was a clinical pilot designed to increase initiation of buprenorphine and methadone for hospitalized patients with OUD requiring post–acute care. The program comprises a hospital partnership with two SNFs and two opioid treatment programs (OTPs) to improve recovery supports and access to MOUD for patients discharged to SNF. Between August 2019 and August 2020, study staff approached 49 hospitalized patients with OUD for participation in OUD MEETS. Twenty-eight of 30 eligible patients enrolled in the program and initiated buprenorphine or methadone. Twenty-seven (96 %) enrolled patients successfully completed hospital treatment. Twenty-three (85 %) patients successfully completed medical treatment at SNF. Thirteen (46 %) enrolled patients had confirmed linkage to OUD treatment post-SNF. One patient left the hospital (4 %) and four patients left SNF (15 %) via PDD. OUD MEETS demonstrates feasibility of hospital, SNF, and OTP partnership to integrate MOUD treatment into SNFs, with high rates of completion of medical treatment and low rates of PDD. Future research should find sustainable ways to improve access to MOUD at post–acute care facilities, including through regulatory and policy changes. •Hospital-SNF partnership for patients with OUD increased SNF treatment completion.•Low rates of patient-directed discharges from both hospital and SNF•Mechanism for in-hospital OTP enrollment allowed for methadone continuation at SNF.