Using inpatient addiction consult service via telehealth to improve pharmacotherapy initiation: An observational study

IntroductionThe COVID-19 pandemic exacerbated existing challenges in treating substance use disorders. This study explores the impact of telehealth on addiction consult services (ACS) medication initiation in hospitalized patients with alcohol and opioid use disorders (AUD and OUD).MethodsWe retrospectively analyzed data from adult patients who received their first ACS consultation in-person (pre-pandemic) and telehealth ACS consultation (during the pandemic). We compared medication initiation rates for AUD and OUD before and after ACS consultation.ResultsThe ACS completed 398 in-person consults and 473 telehealth consults. In-person ACS consultation increased the medication initiation rates from 3.41% for AUD in hospitalized patients without an ACS consult, to 45.45% for AUD after an ACS consult. For OUD pharmacotherapy initiation, an ACS consultation increased medication rates from 6.94% to 41.67% for OUD. Telehealth ACS consultation increased medication initiation rates from 5.16% to 66.20% for AUD and from 7.53% to 67.74% for OUD. Buprenorphine and naltrexone were the most commonly initiated medications for OUD and AUD, respectively.DiscussionThe adoption of telehealth by the hospital ACS during the pandemic effectively increased medication initiation rates for AUD and OUD, consistent with pre-pandemic, demonstrating its potential to expand access to addiction services. This approach could address the current shortage of addiction providers and serve underserved populations.