-
Tytuł:
-
In-Hospital Illicit Drug Use and Patient-Directed Discharge: Barriers to Care for Patients With Injection-Related Infections.
-
Autorzy:
-
Eaton EF; Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Westfall AO; Department of Biostatistics, Ryals School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA.
McClesky B; Department of Pathology, Division of Forensics, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Paddock CS; Department of Psychiatry, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Lane PS; Department of Psychiatry, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Cropsey KL; Department of Psychiatry, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Lee RA; Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA.
-
Źródło:
-
Open forum infectious diseases [Open Forum Infect Dis] 2020 Mar 03; Vol. 7 (3), pp. ofaa074. Date of Electronic Publication: 2020 Mar 03 (Print Publication: 2020).
-
Typ publikacji:
-
Journal Article
-
Język:
-
English
-
Imprint Name(s):
-
Original Publication: Cary, NC : Published by Oxford University Press on behalf of the Infectious Diseases Society of America, [2014]-
-
References:
-
Intern Med J. 2013 Jul;43(7):798-802. (PMID: 23461391)
Ann Fam Med. 2015 Jan-Feb;13(1):23-6. (PMID: 25583888)
Am J Public Health. 2015 Dec;105(12):e53-9. (PMID: 26469651)
J Subst Abuse Treat. 2019 Jul;102:16-22. (PMID: 31202284)
Drug Alcohol Rev. 2015 Sep;34(5):499-502. (PMID: 25944526)
Drug Alcohol Depend. 2018 Sep 1;190:200-208. (PMID: 30055424)
BMJ. 2017 Apr 26;357:j1550. (PMID: 28446428)
J Acquir Immune Defic Syndr. 2004 Jan 1;35(1):56-9. (PMID: 14707793)
Clin Infect Dis. 2019 May 17;68(11):1935-1937. (PMID: 30357363)
PLoS One. 2011;6(9):e24459. (PMID: 21931723)
Soc Sci Med. 2014 Mar;105:59-66. (PMID: 24508718)
Addiction. 2018 Mar;113(3):545-563. (PMID: 28891267)
J Subst Abuse Treat. 2018 Sep;92:64-69. (PMID: 30032946)
Harm Reduct J. 2018 Jul 5;15(1):35. (PMID: 29976203)
J Gen Intern Med. 2017 Mar;32(3):296-303. (PMID: 27957661)
Subst Abus. 2020;41(4):519-525. (PMID: 31638862)
J Gen Intern Med. 2010 Sep;25(9):926-9. (PMID: 20425146)
Cochrane Database Syst Rev. 2014 Feb 06;(2):CD002207. (PMID: 24500948)
Am J Med. 2012 Jun;125(6):594-602. (PMID: 22513194)
Clin Infect Dis. 2019 Mar 5;68(6):1041-1043. (PMID: 30165395)
J Acquir Immune Defic Syndr. 2011 Mar 1;56 Suppl 1:S22-32. (PMID: 21317590)
J Infect Dis. 2020 Sep 2;222(Suppl 5):S499-S505. (PMID: 32877555)
-
Contributed Indexing:
-
Keywords: AMA; IVDU; OUD; hepatitis C; in-hospital drug use
-
Entry Date(s):
-
Date Created: 20200408 Latest Revision: 20240328
-
Update Code:
-
20240329
-
PubMed Central ID:
-
PMC7096133
-
DOI:
-
10.1093/ofid/ofaa074
-
PMID:
-
32258203
-
Background: Hospitalized persons who inject drugs are at a greater risk of adverse hospital outcomes including discharge against medical advice, inpatient illicit drug use, overdose, and death. However, there are limited data on the frequency and outcomes of these events in the United States.
Methods: This retrospective analysis included patients with injection-related infections receiving a protocol for injection drug use (IDU) at University of Alabama at Birmingham Hospital from 2016 to 2017. In-hospital IDU was suspected or reported drug usage plus confirmatory drug screen, and documented discharges "against medical advice" were deemed patient-directed discharges (PDD). We analyzed the frequency of and associations between in-hospital IDU, PDD, 30-day readmission, and deaths (between 2016 and 2019) using McNemar's tests. Logistic regression models evaluated the association between PDD, in-hospital IDU, readmission, and death.
Results: Overall, 83 patients met inclusion criteria: 28 (34%) with in-hospital IDU, 12 (14%) PDD, 9 (11%) died, and 12 (14%) 30-day readmission. In-hospital IDU was significantly associated with PDD ( P = .003), 30-day readmission ( P = .005), and death ( P = .0003). Patient-directed discharges and 30-day readmission were not significantly associated with death nor with each other.
Conclusions: In a cohort of patients receiving inpatient care for injection-related infections, illicit drug use, PDD, 30-day readmissions, and death were common. Furthermore, patients who use illicit drugs while hospitalized are significantly more likely to leave early, be readmitted, and/or die. We must design models of care that prevent adverse outcomes, including drug use and PDD, to reduce barriers to evidence-based treatment of infections.
(© The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
Zaloguj się, aby uzyskać dostęp do pełnego tekstu.
