• Dana Clifton, Noel Ivey, Stephanie Poley, Amy O'Regan, Sudha R Raman, Nicole Frascino, Shavone Hamilton, and Noppon Setji.
• Department of Medicine, Division of General Internal Medicine, Duke University School of Medicine, Durham, North Carolina, USA.
• J Hosp Med. 2022 Jun 1; 17 (6): 427436427-436.

BackgroundAs opioid-related hospitalizations rise, hospitals must be prepared to evaluate and treat patients with opioid use disorder (OUD). We implemented a hospitalist-led program, Project Caring for patients with Opioid Misuse through Evidence-based Treatment (COMET) to address gaps in care for hospitalized patients with OUD.ObjectiveImplement evidence-based treatment for inpatients with OUD and refer to postdischarge care.Design, Setting, And ParticipantsProject COMET launched in July 2019 at Duke University Hospital (DUH), an academic medical center in Durham, NC.Intervention, Main Outcomes, And MeasuresWe engaged key stakeholders, performed a needs assessment, and secured health system funding. We developed protocols to standardize OUD treatment and employed a social worker to facilitate postdischarge care. Electronic health records were utilized for data analysis.ResultsCOMET evaluated 512 patients for OUD during their index hospitalization from July 1, 2019 through June 30, 2021. Seventy-one percent of patients received medication for OUD (MOUD) during admission. Of those who received buprenorphine during admission, 64% received a discharge prescription. Of those who received methadone during admission, 83% of eligible patients were connected to a methadone clinic. Among all patients at DUH with OUD, MOUD use during hospitalization and at discharge increased in the post-COMET period compared to the pre-COMET period (p < .001 for both).ConclusionOur program is one of the first to demonstrate successful implementation of a hospitalist-led, comprehensive approach to caring for hospitalized patients with OUD and can serve as an example to other institutions seeking to implement life-saving, evidence-based treatment in this population.© 2022 The Authors. Journal of Hospital Medicine published by Wiley Periodicals LLC on behalf of Society of Hospital Medicine.

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