S2721 Addiction Medicine Consultation Rates for Inpatients With Alcohol Use Disorder Remain Unchanged After Gastroenterology Led Awareness Efforts

Introduction: The prevalence of alcohol-related hospitalizations is increasing, including among patients with gastroenterological conditions due to alcohol use. The AASLD in its most recent guidelines on alcohol related liver disease, highlights the importance of abstinence and recommends multidisciplinary management with addiction specialists and referral to treatment which includes psychosocial/behavioral and medical approaches. We aimed to explore the barriers to addiction medicine referrals by gastroenterologists and to improve those rates. Methods: We created a questionnaire to identify the barriers to addiction medicine referrals in Eskenazi Hospital, which is the public hospital division of the Health and Hospital Corporation of Marion County serving a diverse population of patients across central Indiana. Our questionnaire was circulated among the Indiana University Gastroenterology department faculty and fellows. We also shared relevant educational material about treatment of alcohol use disorder. We assessed the referral rate to the addiction medicine service before and after the questionnaire and educational material using Epic’s Slicer Dicer tool. Results: We received a total of 27 responses to our questionnaire. This allowed us to identify 2 major barriers to addiction medicine referrals in inpatients with alcohol use disorder (AUD). Those were physicians not knowing that there’s an addiction medicine service at Eskenazi and patient unwillingness to engage in AUD treatments. In the 6 months prior to our study out of 833 inpatients with AUD, 156 (18%) were referred to the addiction service. We waited for 2 months after the questionnaire and educational material distribution and queried Slicer Dicer again. Out of 410 inpatients with AUD, 73 (18%) were referred to addiction medicine. Conclusion: We showed that even after increasing awareness of the available resources, we were not able to increase the referral rates to the addiction medicine service. This is likely due to patient unwillingness to participate in AUD treatment as was highlighted in our questionnaire. Patient-centered educational efforts to improve awareness and openness towards AUD treatments are needed.