Michael A Incze, Sophia Huebler, David Chen, Andrea Stofko, Chaorong Wu, Jacob D Baylis, Chesley Wells, Danielle Babbel
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We used Wilcoxon signed-rank tests to identify the most impactful barriers and facilitators among all respondents. We used logistic regression models to explore the influence of hospitalists' attitudes toward providing SUD care on perceived barriers and facilitators.</p><p><strong>Results: </strong>The survey was distributed to 429 individuals across 15 hospitals. Eighty-two hospitalists responded to the survey (response rate, 21.4%). Most respondents frequently cared for hospitalized patients with SUDs (n = 63, 77%) and prescribed medications for SUDs (n = 44, 56%). Four respondents (5%) felt that patients received adequate support during care transitions. Lack of social support ( P < 0.001) and social factors such as lack of transportation ( P < 0.001) were perceived as the largest barriers to successful care transitions. Conversely, a partnering outpatient clinic/clinician ( P < 0.001) and outpatient-based care coordination ( P < 0.001) were perceived as the strongest facilitators. Respondents' attitudes toward people with SUDs had a modest effect on perceived barriers and facilitators.</p><p><strong>Conclusions: </strong>Hospitalists perceived increased outpatient SUD treatment infrastructure and transitional care supports as most important in facilitating posthospitalization care transitions for patients with SUDs.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":null,"pages":null},"PeriodicalIF":4.2000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Hospitalists' Attitudes and Experiences With Posthospitalization Care Transitions for Patients With Substance Use Disorders: A Cross-sectional Analysis.\",\"authors\":\"Michael A Incze, Sophia Huebler, David Chen, Andrea Stofko, Chaorong Wu, Jacob D Baylis, Chesley Wells, Danielle Babbel\",\"doi\":\"10.1097/ADM.0000000000001305\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Medical hospitalizations are relatively common among individuals who have substance use disorders (SUDs) and represent opportunities for patient engagement and treatment. Posthospitalization transitions of care are an important element of providing full-spectrum inpatient SUD care; however, little is known about clinicians' experiences with postdischarge care transitions.</p><p><strong>Methods: </strong>We conducted a cross-sectional study surveying hospital-based medical clinicians (ie, \\\"hospitalists\\\") across 2 large health systems in the state of Utah to assess current practices, barriers, facilitators, and perceptions toward posthospitalization care transitions for patients with SUDs. We used Wilcoxon signed-rank tests to identify the most impactful barriers and facilitators among all respondents. We used logistic regression models to explore the influence of hospitalists' attitudes toward providing SUD care on perceived barriers and facilitators.</p><p><strong>Results: </strong>The survey was distributed to 429 individuals across 15 hospitals. Eighty-two hospitalists responded to the survey (response rate, 21.4%). Most respondents frequently cared for hospitalized patients with SUDs (n = 63, 77%) and prescribed medications for SUDs (n = 44, 56%). Four respondents (5%) felt that patients received adequate support during care transitions. Lack of social support ( P < 0.001) and social factors such as lack of transportation ( P < 0.001) were perceived as the largest barriers to successful care transitions. Conversely, a partnering outpatient clinic/clinician ( P < 0.001) and outpatient-based care coordination ( P < 0.001) were perceived as the strongest facilitators. 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引用次数: 0
摘要
背景:住院治疗在药物使用障碍(SUD)患者中较为常见,是患者参与和治疗的机会。住院后的护理过渡是提供全方位住院 SUD 护理的一个重要因素;然而,人们对临床医生在出院后护理过渡方面的经验知之甚少:我们对犹他州两家大型医疗系统的医院临床医生(即 "住院医生")进行了一项横断面研究调查,以评估针对 SUD 患者的出院后护理过渡的当前实践、障碍、促进因素和看法。我们使用 Wilcoxon 符号秩检验在所有受访者中找出影响最大的障碍和促进因素。我们使用逻辑回归模型探讨了住院医生提供 SUD 护理的态度对感知到的障碍和促进因素的影响:我们向 15 家医院的 429 人发放了调查问卷。82名医院医生对调查做出了回复(回复率为21.4%)。大多数受访者经常护理患有药物依赖性精神障碍的住院病人(63 人,77%),并开具治疗药物依赖性精神障碍的处方(44 人,56%)。四名受访者(5%)认为患者在护理过渡期间得到了足够的支持。缺乏社会支持(P < 0.001)和交通不便等社会因素(P < 0.001)被认为是成功完成护理过渡的最大障碍。相反,合作门诊/临床医生(P < 0.001)和门诊护理协调(P < 0.001)被认为是最大的促进因素。受访者对 SUD 患者的态度对所感知的障碍和促进因素影响不大:住院医生认为,增加门诊 SUD 治疗基础设施和过渡性护理支持对促进 SUD 患者住院后的护理过渡最为重要。
Hospitalists' Attitudes and Experiences With Posthospitalization Care Transitions for Patients With Substance Use Disorders: A Cross-sectional Analysis.
Background: Medical hospitalizations are relatively common among individuals who have substance use disorders (SUDs) and represent opportunities for patient engagement and treatment. Posthospitalization transitions of care are an important element of providing full-spectrum inpatient SUD care; however, little is known about clinicians' experiences with postdischarge care transitions.
Methods: We conducted a cross-sectional study surveying hospital-based medical clinicians (ie, "hospitalists") across 2 large health systems in the state of Utah to assess current practices, barriers, facilitators, and perceptions toward posthospitalization care transitions for patients with SUDs. We used Wilcoxon signed-rank tests to identify the most impactful barriers and facilitators among all respondents. We used logistic regression models to explore the influence of hospitalists' attitudes toward providing SUD care on perceived barriers and facilitators.
Results: The survey was distributed to 429 individuals across 15 hospitals. Eighty-two hospitalists responded to the survey (response rate, 21.4%). Most respondents frequently cared for hospitalized patients with SUDs (n = 63, 77%) and prescribed medications for SUDs (n = 44, 56%). Four respondents (5%) felt that patients received adequate support during care transitions. Lack of social support ( P < 0.001) and social factors such as lack of transportation ( P < 0.001) were perceived as the largest barriers to successful care transitions. Conversely, a partnering outpatient clinic/clinician ( P < 0.001) and outpatient-based care coordination ( P < 0.001) were perceived as the strongest facilitators. Respondents' attitudes toward people with SUDs had a modest effect on perceived barriers and facilitators.
Conclusions: Hospitalists perceived increased outpatient SUD treatment infrastructure and transitional care supports as most important in facilitating posthospitalization care transitions for patients with SUDs.
期刊介绍:
The mission of Journal of Addiction Medicine, the official peer-reviewed journal of the American Society of Addiction Medicine, is to promote excellence in the practice of addiction medicine and in clinical research as well as to support Addiction Medicine as a mainstream medical sub-specialty.
Under the guidance of an esteemed Editorial Board, peer-reviewed articles published in the Journal focus on developments in addiction medicine as well as on treatment innovations and ethical, economic, forensic, and social topics including:
•addiction and substance use in pregnancy
•adolescent addiction and at-risk use
•the drug-exposed neonate
•pharmacology
•all psychoactive substances relevant to addiction, including alcohol, nicotine, caffeine, marijuana, opioids, stimulants and other prescription and illicit substances
•diagnosis
•neuroimaging techniques
•treatment of special populations
•treatment, early intervention and prevention of alcohol and drug use disorders
•methodological issues in addiction research
•pain and addiction, prescription drug use disorder
•co-occurring addiction, medical and psychiatric disorders
•pathological gambling disorder, sexual and other behavioral addictions
•pathophysiology of addiction
•behavioral and pharmacological treatments
•issues in graduate medical education
•recovery
•health services delivery
•ethical, legal and liability issues in addiction medicine practice
•drug testing
•self- and mutual-help.