Integrated Infectious Disease and Substance Use Disorder Care for the Treatment of Injection Drug Use–Associated Infections: A Prospective Cohort Study With Historical Control

作者：David Phillip Serota, Liza M. Rosenbloom, Belén Hervera, Grace Seo, Daniel J. Feaster, Lisa R. Metsch, Edward Suarez, Teresa A. Chueng, Salma Hernandez, Allan E. Rodriguez, Hansel E. Tookes, Susanne Doblecki‐Lewis, Tyler S. Bartholomew · 发表于：Open Forum Infectious Diseases · 年份：2022 · DOI：10.1093/ofid/ofac688 · 被引用次数：28 · 研究领域：HIV, Drug Use, Sexual Risk、Opioid Use Disorder Treatment、Substance Abuse Treatment and Outcomes

Abstract Background To address the infectious disease (ID) and substance use disorder (SUD) syndemic, we developed an integrated ID/SUD clinical team rooted in harm reduction at a county hospital in Miami, Florida. The Severe Injection-Related Infection (SIRI) team treats people who inject drugs (PWID) and provides medical care, SUD treatment, and patient navigation during hospitalization and after hospital discharge. We assessed the impact of the SIRI team on ID and SUD treatment and healthcare utilization outcomes. Methods We prospectively collected data on patients seen by the SIRI team. A diagnostic code algorithm confirmed by chart review was used to identify a historical control group of patients with SIRI hospitalizations in the year preceding implementation of the SIRI team. The primary outcome was death or readmission within 90 days post–hospital discharge. Secondary outcomes included initiation of medications for opioid use disorder (MOUD) and antibiotic course completion. Results There were 129 patients included in the study: 59 in the SIRI team intervention and 70 in the pre-SIRI team control group. SIRI team patients had a 45% risk reduction (aRR, 0.55 [95% confidence interval CI, .32–.95]; 24% vs 44%) of being readmitted in 90 days or dying compared to pre-SIRI historical controls. SIRI team patients were more likely to initiate MOUD in the hospital (93% vs 33%, P < .01), complete antibiotic treatment (90% vs 60%, P < .01), and less likely to have patient-direct...