Session : Current Issues in Public Health

83 - A Descriptive Analysis of a Multi-disciplinary Approach to Opioid Use Disorder Treatment Within an Infectious Diseases Clinic

Oral Abstract

Location: On Demand

Background: Opioid overdose is the leading cause of injury-related death in the US. Kentucky ranks in the top 5 states for opioid overdose deaths. The rate of injection drug use-associated infections (IDU-AI) has risen; the University of Kentucky Infectious Diseases division (UKID) treated 401 endocarditis cases in 2018, of which 73% were IDU-AI. To curb overdose deaths, ease financial burden on healthcare, and improve patient outcomes, patients need tools for recovery from opioid use disorder (OUD). Access to OUD treatment in Kentucky and much of the US is limited. Poverty, unemployment, and legal issues are barriers.

Methods: UKID implemented a multi-disciplinary approach to expand access to medication assisted treatment (MAT). This is an ongoing study. Any patient ≥18 years old with IDU-AI and OUD is eligible for enrollment unless pregnant or incarcerated. At enrollment and at three additional time points, patients complete both a study specific and Government Performance and Results Act (GPRA) survey. Patients may start MAT and mental health counseling with UKID or be referred elsewhere and are eligible for transportation assistance and medical case management.

Results: To date, there have been 127 referrals. Of these, 87 (69%) were eligible and 54 enrolled (62% of eligible). Primary IVDU-AI includes HIV (n=4; 7%), HCV (n=5; 9%), HIV/HCV (n=3; 6%), endocarditis (n=32; 59%), and other (n=10; 19%). Patients are 48% male (n=26) and 91% white (n=91) with a median age of 34 years (IQR: 16); 35% are receiving MAT (n=19) with 14.8% (n=8) managed by UKID. Other service data are available for 51 patients. Naloxone was dispensed to 45 (88%) patients, 24 (47%) received relapse prevention services, 13 (25%) engaged in peer support, 9 (18%) participated in self-help groups, and 10 (20%) received transportation aid.

Conclusion: Increasing engagement in MAT and wrap-around services is an important touchpoint for OUD. We present a comprehensive program to achieve this for patients who would otherwise be discharged without follow-up for OUD. This program shows proof of concept that patients can be engaged in MAT by ID providers. Ongoing analysis will include longitudinal review of patient progress and outcomes, including hospital readmission, and a study to determine patients’ perceived impact on their quality of life.

Presenting Author(s)

Sarah R. Blevins, PharmD

HIV Clinical Pharmacist
University of Kentucky HealthCare
Lexington, Kentucky

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Slides Slides and Audio

Co-Author(s)

TS

Tiffany Stivers, MSN, APRN

Advanced Practice Provider
University of Kentucky
Lexington, Kentucky

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
KS

Kathryn Sabitus, MS

Research Program Manager
University of Kentucky HealthCare
Lexington, Kentucky

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
RW

Ryan Weeks, BS

Project Data Manager
University of Kentucky HealthCare
Lexington, Kentucky

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
JP

J. Zachary Porterfield, MD, PhD

Assistant Professor
University of Kentucky College of Medicine
Lexington, Kentucky

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
AT

Alice Thornton, MD

Professor
University of Kentucky
Lexington, Kentucky

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.