Work

Impact of Substance Use Navigators on Initiation of Treatment for Substance Use Disorders and 30-Day Unplanned Readmission

Year: 2025

Type: article

Abstract: BACKGROUND: The prevalence of substance use disorders (SUDs) is high among hospitalized patients, yet adoption of evidence-based practices to address SUDs in this population is limited. Substance use navigators (SUNs) are a promising intervention for improving patient outcomes. OBJECTIVE: This study aimed to quantify the impact of SUN consultations on medications for opioid use disorder (MOUD) and medications for alcohol use disorder (MAUD) initiation and 30-day unplanned readmissions in hospitalized patients with SUDs. DESIGN: A retrospective observational cohort study at a rural hospital in Northern California following adoption of the CA Bridge model of using SUNs to provide low-threshold, evidence-based treatment for SUDs. Patient data were extracted from electronic medical records. PATIENTS: Hospitalized patients with a primary or secondary diagnosis of alcohol use disorder or opioid use disorder in 2023. MAIN MEASURES: The two outcomes of interest were MOUD and MAUD initiation and 30-day unplanned readmission. Propensity score matching was used to estimate risk ratios comparing outcomes for patients who did vs. did not receive SUN consultation. KEY RESULTS: Among 781 patients, 26.6% received a SUN consultation and the most common primary diagnosis was sepsis (9%). MOUD and MAUD were initiated among 15.7% of patients who had a SUN consultation and 7% who did not, and the 30-day unplanned readmission rate was 4% for patients who had a SUN consultation and 10.9% for those who did not. In the propensity score matched analysis, having a SUN consultation was associated with a twofold increase in MOUD/MAUD initiation (RR 2.29, 95%CI 1.27-4.11) and a 64% reduction in risk of 30-day unplanned readmission (RR 0.36, 95%CI 0.17-0.80). CONCLUSIONS: Adoption of SUNs may be an effective strategy for improving quality of care for patients with SUDs and reducing costs associated with unplanned readmissions at community-based hospitals without addiction medicine consult services.

Source: Journal of General Internal Medicine

DOI: 10.1007/s11606-025-09902-y