A new study published in Clinical Infectious Diseases indicates that administering medications used to treat opioid use disorder after hospital discharge may improve outcomes for endocarditis.
“Endocarditis, once predominately found in older adults, is increasingly common among younger persons who inject drugs,” the authors wrote in their abstract. “Untreated opioid use disorder complicates endocarditis management. We aimed to determine if rates of overdose and rehospitalization differ between persons with opioid use disorder with endocarditis who are initiated on medications for opioid use disorder (MOUDs) within 30 days of hospital discharge and those who are not.”
The retrospective cohort study included data on 768 individuals (51% male, mean age 39 years) from a large commercial health insurance database. The primary study outcomes of interest were opioid-related overdose and one-year all-cause rehospitalization. The authors calculated incidence rates for the outcomes and used Cox hazard models to predict time from discharge to each outcome as a function of MOUDs administration.
According to the results, only 5.7% of the individuals received MOUDs within 30 days of hospitalization. Opioid overdose rates in the 30 days after hospitalization dropped with the administration of the medications. Additionally, the rate of one-year hospitalization in those receiving the medications was also lower compared with those who did not receive MOUDs. In the Cox hazards models, receiving MOUDs was not associated with either of the outcomes.
“This is among the first data to show the life-saving impact that medications to treat opioid use disorder can have on patients with injection drug use-related endocarditis,” said Joshua Barocas, MD, an infectious disease physician and researcher at Boston Medical Center, said in a news release. “Given the increase in injection drug use-related infections, it is critical to treat the underlying opioid use disorder, which often leads to these serious complications and inpatient hospitalizations.”
Dr. Barocas added that MOUDs should be part of a comprehensive treatment plan that includes outpatient care and harm-reduction services.
“We need to ensure that patients have access to the evidence-based treatment and services that will help reduce their risk of infection and overdose, as well as help them achieve long-term recovery,” he said.
— Ingentium (@Ingentium_Inc) January 23, 2020