Prevalence, Patterns and Predictors of Prescribing Medications for Opioid Use Disorder (MOUD) in the Inpatient Setting

Abstract

BackgroundThere are many barriers to prescribing medications for opioid use disorder (MOUD). This study evaluates the prevalence, patterns, and predictors of inpatient MOUD prescribing at discharge to patients with a diagnosis of opioid use/opioid use disorder (OUD) that developed opioid withdrawal during their hospital stay. MethodsThis multicenter, retrospective cross-sectional study occurred at three hospitals in Arizona. Patients who developed opioid withdrawal during their hospitalization and had a documented opioid-related disorder between January 1, 2021, and January 1, 2022, were included in the study. Patient-specific factors were evaluated as predictors of MOUD prescribing at hospital discharge using descriptive, multivariate regression. ResultsA total of 382 encounters were included; 249 had documented OUD (65.2%), 75 of which were discharged with MOUD (75/249; 30.1%). Patients with moderate/moderately severe opioid withdrawal had higher odds of being discharged with MOUD compared to those with mild opioid withdrawal (OR 2.87 [1.44-5.69], p=0.003). Patients admitted to the largest hospital in Phoenix had higher odds of being prescribed MOUD compared to the largest hospital in Tucson (OR 8.23 [3.02-22.49], p<0.001), as were patients who underwent a routine discharge compared to patient directed discharges (7.63 [2.35-24.71], p=0.001). ConclusionsLess than one-third of patients with OUD that developed opioid withdrawal during their hospitalization were prescribed MOUD at discharge. Treatment facility, opioid withdrawal severity, and discharge disposition were predictors of MOUD prescribing. Inpatient health-systems and policymakers may consider these data when developing policies/procedures aimed at increasing MOUD prescribing rates.