ArticleThe International journal on drug policy2021
A qualitative assessment of discharge against medical advice among patients hospitalized for injection-related bacterial infections in West Virginia.
Article in The International journal on drug policy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed.
- Short-Acting Opioid Dose and Patient-Directed Discharge in Hospitalized Patients With Opioid Use Disorder.JAMA network open · 2026Article
- Patient-Directed Discharge Among Hospitalized Persons With Opioid Use Disorder in the Fentanyl Era: A Scoping Review.American journal of medicine open · 2026Review
- Failure to Treat Opioid Use Disorder and Opioid Withdrawal Associated with Patient-Directed Discharge in People with Injection-Related Infections.Journal of general internal medicine · 2026Article
- Bacterial and fungal infections in persons who inject drugs.Clinical microbiology reviews · 2025Review
- Treatment of Inpatient Opioid Withdrawal with Short-Acting Full Agonist Opioids at a Safety-Net Hospital.Journal of general internal medicine · 2025Article
- Readmissions and Mortality After "Before Medically Advised" Hospital Discharges Among Medicare Beneficiaries with Opioid Use Disorder.Journal of general internal medicine · 2025Article
- Improving Equity at Premature Discharge: Reframing Discharge Against Medical Advice Using the Structural Competency Framework.Journal of general internal medicine · 2025Article
- Examining geographic disparities in access to no-cost naloxone in North Carolina: A cross-sectional survey of naloxone distribution programs.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- "You don't have the right resources to let it hurt": How structural vulnerabilities shape opioid withdrawal experiences among a community sample of people who inject drugs in Los Angeles, California.Harm reduction journal · 2025Article
- Hospital Security Searches Among Patients With Substance-Related Encounters.JAMA network open · 2025Article
- Exploring the value and acceptability of a patient navigator program for people who inject drugs and are hospitalized for bacterial infections: patients', community organization and healthcare workers' perspectives.BMC infectious diseases · 2025Article
- "Oh, Another Overdose, for the Love of Pete": First Responder Perspectives on Overdose Response Technology.The western journal of emergency medicine · 2025Article
- Drug-related stigma among people who inject drugs - development and validation of the drug use stigma scale (DUSS).PloS one · 2025Article
- Chronic opioid use is associated with higher antibody response to influenza vaccination in people living with HIV.Frontiers in immunology · 2025Article
- Medication for Opioid Use Disorder After Serious Injection-Related Infections in Massachusetts.JAMA network open · 2024Article
- Perspectives of healthcare workers on the integration of overdose detection technologies in acute care settings.Addiction science & clinical practice · 2024Article
- Characterizing Opioid Withdrawal Experiences and Consequences Among a Community Sample of People Who Use Opioids.Substance use & misuse · 2024Article
- Prevalence and incidence of emergency department presentations and hospital separations with injecting-related infections in a longitudinal cohort of people who inject drugs.Epidemiology and infection · 2023Article
- An Analysis of Irregular Discharges From Residential Treatment Programs in the Department of Veterans Affairs Health Care System.Military medicine · 2023Article
- Characterization of patients receiving surgical versus non-surgical treatment for infective endocarditis in West Virginia.PloS one · 2023Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundThe incidence of infective endocarditis (IE) and other systemic bacterial infections is increasing, and people who inject drugs (PWID) have higher rates of discharge against medical advice (AMA) for these infections than patients whose infections are not injection-related. In this study, we characterize factors that contribute to AMA hospital discharge among PWID.
methodsWe conducted qualitative interviews with twenty PWID hospitalized with serious injection-related bacterial infections in West Virginia. Participants completed a brief survey and in-depth qualitative interview. Interviews were recorded and transcribed verbatim and analyzed using a codebook developed based on deductive and inductive thematic analysis. We also conducted medical records abstraction and used descriptive statistics to summarize medical and survey data.
resultsAverage age was 34 years, 55% were female, 95% identified as white, and 75% had a primary diagnosis of IE. Drugs injected prior to hospitalization were methamphetamine (60%), prescription opioids (38%), and/or heroin/fentanyl (25%). Participants cited multiple contributors to AMA discharge including negative interactions with hospital staff that they perceived as stigmatizing, including being searched or monitored for illicit drug use; inadequate management of pain and withdrawal; boredom and confinement during lengthy hospitalizations; and isolation from family and other social supports.
conclusionWe identified multiple factors contributing to AMA discharge that are amenable to intervention. Given the significant morbidity, mortality, and financial costs associated with hospitalizing PWID for serious injection-related bacterial infections, hospitals should be highly motivated to develop and test interventions designed to improve outcomes among these patients.
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