Addiction consult service involvement in PrEP and PEP delivery for patients who inject drugs admitted to an urban essential hospital
Rattachement africain : us. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: Addiction medicine providers have a key role in HIV prevention amidst rising HIV incidence in persons who inject drugs (PWID). Pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) are vastly underutilized in this population. Inpatient hospitalization represents a potential touchpoint for initiation of HIV prophylaxis, though little research explores the role of addiction providers. Here we describe rates of PrEP/PEP delivery to hospitalized PWID seen by an Addiction Consult Service (ACS) at an urban, essential hospital. METHODS: We performed a cross-sectional study of hospitalized patients who were seen by the ACS from January 1, 2020 to December 31, 2022 and had plausible injection drug use. We calculated the proportion of patients who received a new prescription for PrEP/PEP at discharge. We used descriptive statistics to characterize demographics, substance use, reason for admission, and indications for PrEP/PEP. Secondarily, we calculated the monthly proportion of all patients discharged from the hospital with PrEP/PEP who were seen by the ACS compared to those not seen by the ACS. RESULTS: The average monthly proportion of ACS consults with plausible injection drug use who received PrEP/PEP was 6.4%. This increased from 4.2% in 2020 to 7.5% in 2022. Those seen by the ACS who received PrEP/PEP had high rates of opioid use disorder (97.5%), stimulant use disorder (77.8%), and homelessness (58.1%); over half were admitted for an injection-related infection. The indications for PrEP/PEP were injection drug use only (70.6%), followed by combined injection and sexual risk (20.2%); 71.9% of prescriptions were for PrEP and 28.1% for PEP. Overall, the ACS was involved in 83.9% of hospital-wide discharges with PrEP/PEP prescriptions (n = 242). CONCLUSIONS: PWID who were seen by the ACS received PrEP/PEP prescriptions at rates exceeding national averages. The ACS was also involved with the care of the majority of admitted patients who received PrEP/PEP at discharge. While PrEP/PEP use for PWID remains low, the inpatient ACS represents a key resource to improve uptake by leveraging the reachable moment of an inpatient hospitalization.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Addiction consult service involvement in PrEP and PEP delivery for patients who inject drugs admitted to an urban essential hospital
- Date Crossref
- 04/11/2024
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Boston University Section of General Internal Medicine pays non établi dans la noticeUniversité ou école supérieure
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Boston Medical Center Grayken Center for Addiction pays non établi dans la noticeÉtablissement de santé
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University of Colorado Denver pays non établi dans la noticeUniversité ou école supérieure
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Boston Health Care for the Homeless Program pays non établi dans la noticeÉtablissement de santé
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University of Miami Hospital pays non établi dans la noticeÉtablissement de santé
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National Patient Safety Foundation pays non établi dans la noticeOrganisation à but non lucratif
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University of Colorado School of Medicine Division of General Internal Medicine pays non établi dans la noticeUniversité ou école supérieure
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Boston Healthcare for the Homeless Program pays non établi dans la noticeInstitution
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University of Miami Miller School of Medicine Division of Hospital Medicine pays non établi dans la noticeUniversité ou école supérieure
Section of General Internal Medicine — Boston University, Grayken Center for Addiction — Boston Medical Center et University of Colorado Denver, avec 6 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.