Scaling the model of care for patients with opioid use disorder

Data show that concurrent with the opioid overdose crisis, there has been an increase in hospitalizations of people with opioid use disorder (OUD). One in ten of these hospitalized medical or surgical patients have comorbid opioid-related diagnoses.

Research from the University of Pennsylvania School of Nursing (Penn Nursing) documents existing models of care for these patients and defines essential components of such models to set a standard of hospital care. The review is the first of its kind to systematically document components, staffing models, and outcomes of existing interventions.

The review, published in the journal Substance Abuse, found that interventions with the best evidence of efficacy often employ an addiction medicine consult service that facilitates connection to post-discharge OUD care and includes addiction medicine physicians as part of a team.

"There is a clear need for interventions targeted at this population," says Rachel French, Ph.D., RN, a postdoctoral fellow in the National Clinician Scholars Program at Penn Nursing and Penn Medicine and lead investigator. "Implementation strategies may represent an untapped lever for scaling models of care for these patients while ensuring that interventions actively mitigate existing racial disparities in access to care."

The article "Interventions for Hospitalized Medical and Surgical Patients with Opioid Use Disorder: A Systematic Review" is available online. Co-authors of the article are all from Penn Nursing and include Shoshana V. Aronowitz, Ph.D., CRNP; J. Margo Brooks Carthon, Ph.D., RN, FAAN, Tyson Family Endowed Term Chair for Gerontological Research and Associate Professor of Nursing; Heath D. Schmidt, Ph.D., Associate Professor of Nursing; and Peggy Compton, PHD, RN, FAAN, van Ameringen Chair in Psychiatric and Mental Health Nursing and Associate Professor of Nursing.