51. Implementing a peer-supported, integrated strategy for substance use disorder care in an outpatient infectious disease clinic is associated with improved patient outcomes.
- Author
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Falade-Nwulia, Oluwaseun, Agee, Tracy, Kelly, Sharon M., Park, Ju Nyeong, Schwartz, Sheree, Hsu, Jeffrey, Schweizer, Nicholas, Jones, Joyce, Keruly, Jeanne, Shah, Nishant, Lesko, Catherine R., Lucas, Gregory M., and Sulkowski, Mark
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SUBSTANCE abuse treatment , *AFFINITY groups , *PATIENT aftercare , *NARCOTICS , *SOCIAL support , *HOSPITAL emergency services , *CONVALESCENCE , *BUPRENORPHINE , *HEALTH outcome assessment , *CLINICS , *HUMAN services programs , *DESCRIPTIVE statistics , *COCAINE , *HOSPITAL care , *INTEGRATED health care delivery , *MEDICAL prescriptions , *DRUGS of abuse , *MEDICAL appointments - Abstract
Substance use disorder (SUD) and infectious disease (ID) care integration may lead to improvements in SUD and ID outcomes. We assessed implementation of integrating peer-supported SUD care in an outpatient ID setting. In this implementation study, we describe REcovery in Specialty care Through medication and OutREach (RESTORE), a low-threshold SUD program implemented in a Baltimore outpatient ID clinic. Key program components were clinician training and support in SUD care, prescription of SUD treatment medications, and peer-based psychosocial support provided by peer recovery specialists. We assessed clinician adoption of RESTORE and compared patient outcomes from baseline to 6 months. Between January 2019 and January 2022, the number of ID clinicians (N=61) who prescribed buprenorphine increased eightfold from 3 (5%) to 24 (39%). Of 258 ID patients referred to RESTORE, 182 (71%) engaged, 137 consented to study participation. Mean age in the study sample was 52.1 (SD=10.4), 63% were male, 84% were Black/African-American. Among 127 (93%) who completed 6-month follow-up, fewer participants reported illicit/non-prescribed opioid use in the past 30 days at follow-up (32%) compared to baseline (52%; p<0.001). Similar reductions were noted for cocaine use (47% to 34%; p=0.006), emergency department visits (23% to 9%; p=0.002), and inpatient hospitalizations (15% to 7%; p=0.025). SUD care integration into an outpatient ID care setting using a peer-supported implementation strategy was adopted by clinicians and improved clinical outcomes for patients. This strategy is a promising approach to treating people with infectious diseases and SUD. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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