Evidence map›Paper›PMID 39497126›Full record

ArticleAddiction science & clinical practice2024

Addiction consult service involvement in PrEP and PEP delivery for patients who inject drugs admitted to an urban essential hospital.

Hallie Rozansky, Paul J Christine, Morgan Younkin, Jason M Fox, Zoe M Weinstein, Sebastian Suarez, Jessica Stewart, Natalija Farrell, Jessica L Taylor

Abstract read
In one paragraph

Article in Addiction science & clinical practice, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Hallie RozanskySection of General Internal Medicine, Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center, 801 Massachusetts Avenue, Second Floor, Boston, MA, 02118, USA. hallie.rozansky@bmc.org.ORCID 0000-0002-7762-5901
Paul J ChristineDivision of General Internal Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
Morgan YounkinBoston Healthcare for the Homeless Program, Boston, MA, USA.
Jason M FoxSection of General Internal Medicine, Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center, 801 Massachusetts Avenue, Second Floor, Boston, MA, 02118, USA.
Zoe M WeinsteinSection of General Internal Medicine, Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center, 801 Massachusetts Avenue, Second Floor, Boston, MA, 02118, USA.
Sebastian SuarezDivision of Hospital Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.
Jessica StewartCenter for Infectious Diseases, Boston Medical Center, Boston, MA, USA.
Natalija FarrellDepartment of Quality and Patient Safety, Boston Medical Center, Boston, MA, USA.
Jessica L TaylorSection of General Internal Medicine, Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center, 801 Massachusetts Avenue, Second Floor, Boston, MA, 02118, USA.

Funding

Advancing Clinical Research Training within Addiction Residency ProgramsR25DA033211 · NIDA · BOSTON MEDICAL CENTER · PI Patrick O'Connor, JEFFREY H. SAMET · 2012 to 2026
$4.2M
Massachusetts Department of Public Health 1NTF230M03163724179Massachusetts Department of Public Health INTF4944MM3181926007NIDA NIH HHS R25 DA033211Research in Addiction Medicine Scholars (RAMS) Program R25DA033211
6 · The paper itself

Abstract

backgroundAddiction 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.

methodsWe 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.

resultsThe 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).

conclusionsPWID 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.

Indexed as

HIV InfectionsHospitals, UrbanPre-Exposure ProphylaxisSubstance Abuse, IntravenousAdultCross-Sectional StudiesFemaleHospitalizationHumansMaleMiddle AgedReferral and ConsultationHIV preventionOpioid use disorderPeople who inject drugsPre-exposure prophylaxis

Identifiers

PMID39497126
PMCPMC11533369

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.