Initiating Medications During Hospitalization and Strategies for Ensuring Linkage at Discharge for Patients With Opioid Use Disorder: A Scoping Review
Hospitalization presents a critical opportunity to initiate medications for opioid use disorder (MOUD) and improve long-term outcomes for patients with opioid use disorder (OUD). While inpatient MOUD initiation significantly reduces mortality and relapse, many patients lack appropriate follow-up car...
Saved in:
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-12-01
|
| Series: | American Journal of Medicine Open |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667036425000275 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849229212091678720 |
|---|---|
| author | Austin Drysch Kathryn Fink Nikhil Sriram Marianne Kanaris Scott Wu Deep Upadhyay Katherine Welter Lisa Blankenship Melissa Bregger Kelli Scott Brent Schnipke Ashti Doobay-Persaud |
| author_facet | Austin Drysch Kathryn Fink Nikhil Sriram Marianne Kanaris Scott Wu Deep Upadhyay Katherine Welter Lisa Blankenship Melissa Bregger Kelli Scott Brent Schnipke Ashti Doobay-Persaud |
| author_sort | Austin Drysch |
| collection | DOAJ |
| description | Hospitalization presents a critical opportunity to initiate medications for opioid use disorder (MOUD) and improve long-term outcomes for patients with opioid use disorder (OUD). While inpatient MOUD initiation significantly reduces mortality and relapse, many patients lack appropriate follow-up care after discharge. This scoping review synthesizes evidence from 52 studies on hospital discharge practices for patients with OUD initiated on MOUD to identify best practices that support continued treatment and recovery. Inpatient addiction consultation services, standardized protocols, and clinician education emerged as key facilitators of MOUD initiation. Transitional care strategies, such as bridge clinics, peer navigation, telemedicine, and structured discharge planning, were associated with increased outpatient linkage, reduced readmissions, and improved retention in treatment. Despite policy advances including X-waiver elimination, systemic barriers persist and disproportionately affect rural and minoritized populations. Multidisciplinary, patient-centered discharge pathways that integrate medical treatment with social support are critical. Effective linkage strategies must address both structural and individual barriers to care. We propose six pillars of MOUD continuity, including early initiation, warm handoffs, peer support, bridge care models, telemedicine integration, and attention to social determinants. Implementing these strategies is essential to closing care gaps and improving outcomes in the evolving landscape of MOUD treatment. |
| format | Article |
| id | doaj-art-0c8467d98ea54b5ba1f566c311a3d886 |
| institution | Kabale University |
| issn | 2667-0364 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Medicine Open |
| spelling | doaj-art-0c8467d98ea54b5ba1f566c311a3d8862025-08-22T04:58:36ZengElsevierAmerican Journal of Medicine Open2667-03642025-12-011410011310.1016/j.ajmo.2025.100113Initiating Medications During Hospitalization and Strategies for Ensuring Linkage at Discharge for Patients With Opioid Use Disorder: A Scoping ReviewAustin Drysch0Kathryn Fink1Nikhil Sriram2Marianne Kanaris3Scott Wu4Deep Upadhyay5Katherine Welter6Lisa Blankenship7Melissa Bregger8Kelli Scott9Brent Schnipke10Ashti Doobay-Persaud11Division of Hospital Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL; Requests for reprints should be addressed to Austin Drysch, BS, Division of Hospital Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, 676 N. St. Clair St., Suite 2300, Chicago, IL 60611.Division of Hospital Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, ILDivision of Hospital Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, ILDivision of Hospital Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, ILDivision of Hospital Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, ILDivision of Hospital Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, ILDivision of Hospital Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, ILDivision of Hospital Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, ILDivision of Hospital Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, ILCenter for Dissemination and Implementation Science, Northwestern University Feinberg School of Medicine, Chicago, ILDepartment of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, ILDivision of Hospital Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, ILHospitalization presents a critical opportunity to initiate medications for opioid use disorder (MOUD) and improve long-term outcomes for patients with opioid use disorder (OUD). While inpatient MOUD initiation significantly reduces mortality and relapse, many patients lack appropriate follow-up care after discharge. This scoping review synthesizes evidence from 52 studies on hospital discharge practices for patients with OUD initiated on MOUD to identify best practices that support continued treatment and recovery. Inpatient addiction consultation services, standardized protocols, and clinician education emerged as key facilitators of MOUD initiation. Transitional care strategies, such as bridge clinics, peer navigation, telemedicine, and structured discharge planning, were associated with increased outpatient linkage, reduced readmissions, and improved retention in treatment. Despite policy advances including X-waiver elimination, systemic barriers persist and disproportionately affect rural and minoritized populations. Multidisciplinary, patient-centered discharge pathways that integrate medical treatment with social support are critical. Effective linkage strategies must address both structural and individual barriers to care. We propose six pillars of MOUD continuity, including early initiation, warm handoffs, peer support, bridge care models, telemedicine integration, and attention to social determinants. Implementing these strategies is essential to closing care gaps and improving outcomes in the evolving landscape of MOUD treatment.http://www.sciencedirect.com/science/article/pii/S2667036425000275Bridge clinicsHospital discharge planningMedications for opioid use disorderOpioid use disorderTransitional care strategies |
| spellingShingle | Austin Drysch Kathryn Fink Nikhil Sriram Marianne Kanaris Scott Wu Deep Upadhyay Katherine Welter Lisa Blankenship Melissa Bregger Kelli Scott Brent Schnipke Ashti Doobay-Persaud Initiating Medications During Hospitalization and Strategies for Ensuring Linkage at Discharge for Patients With Opioid Use Disorder: A Scoping Review American Journal of Medicine Open Bridge clinics Hospital discharge planning Medications for opioid use disorder Opioid use disorder Transitional care strategies |
| title | Initiating Medications During Hospitalization and Strategies for Ensuring Linkage at Discharge for Patients With Opioid Use Disorder: A Scoping Review |
| title_full | Initiating Medications During Hospitalization and Strategies for Ensuring Linkage at Discharge for Patients With Opioid Use Disorder: A Scoping Review |
| title_fullStr | Initiating Medications During Hospitalization and Strategies for Ensuring Linkage at Discharge for Patients With Opioid Use Disorder: A Scoping Review |
| title_full_unstemmed | Initiating Medications During Hospitalization and Strategies for Ensuring Linkage at Discharge for Patients With Opioid Use Disorder: A Scoping Review |
| title_short | Initiating Medications During Hospitalization and Strategies for Ensuring Linkage at Discharge for Patients With Opioid Use Disorder: A Scoping Review |
| title_sort | initiating medications during hospitalization and strategies for ensuring linkage at discharge for patients with opioid use disorder a scoping review |
| topic | Bridge clinics Hospital discharge planning Medications for opioid use disorder Opioid use disorder Transitional care strategies |
| url | http://www.sciencedirect.com/science/article/pii/S2667036425000275 |
| work_keys_str_mv | AT austindrysch initiatingmedicationsduringhospitalizationandstrategiesforensuringlinkageatdischargeforpatientswithopioidusedisorderascopingreview AT kathrynfink initiatingmedicationsduringhospitalizationandstrategiesforensuringlinkageatdischargeforpatientswithopioidusedisorderascopingreview AT nikhilsriram initiatingmedicationsduringhospitalizationandstrategiesforensuringlinkageatdischargeforpatientswithopioidusedisorderascopingreview AT mariannekanaris initiatingmedicationsduringhospitalizationandstrategiesforensuringlinkageatdischargeforpatientswithopioidusedisorderascopingreview AT scottwu initiatingmedicationsduringhospitalizationandstrategiesforensuringlinkageatdischargeforpatientswithopioidusedisorderascopingreview AT deepupadhyay initiatingmedicationsduringhospitalizationandstrategiesforensuringlinkageatdischargeforpatientswithopioidusedisorderascopingreview AT katherinewelter initiatingmedicationsduringhospitalizationandstrategiesforensuringlinkageatdischargeforpatientswithopioidusedisorderascopingreview AT lisablankenship initiatingmedicationsduringhospitalizationandstrategiesforensuringlinkageatdischargeforpatientswithopioidusedisorderascopingreview AT melissabregger initiatingmedicationsduringhospitalizationandstrategiesforensuringlinkageatdischargeforpatientswithopioidusedisorderascopingreview AT kelliscott initiatingmedicationsduringhospitalizationandstrategiesforensuringlinkageatdischargeforpatientswithopioidusedisorderascopingreview AT brentschnipke initiatingmedicationsduringhospitalizationandstrategiesforensuringlinkageatdischargeforpatientswithopioidusedisorderascopingreview AT ashtidoobaypersaud initiatingmedicationsduringhospitalizationandstrategiesforensuringlinkageatdischargeforpatientswithopioidusedisorderascopingreview |