Addressing the Health Needs of People Who Inject Drugs: A Descriptive Analysis of an Inpatient Integrated Care Team Within an Acute Hospital in Scotland.

Background: People who inject drugs (PWID) experience poor health outcomes secondary to infective sequelae with lengthy hospitalizations, high rates of unplanned discharge, and frequent readmissions. Challenges arranging and engaging with outpatient services compound these issues. Methods: An integrated team consisting of infectious diseases, drug liaison, and assertive outreach was established in January 2023 at a secondary-care hospital in Edinburgh, Scotland. We assessed the medical needs of patients hospitalized with injection-related infections and considered the impact of this service by comparing health outcomes of patients seen by the integrated team against a historic cohort. Primary descriptive analysis included type and severity of infection, and outcomes included referral to outpatient services and meeting recommended care standards such as blood-borne virus (BBV) screening. Results: The integrated team saw 37 patients (43 hospital admissions), and 65 patients (73 admissions) were identified as historic controls. Patients seen by the integrated team experienced more severe and complex infections including 37.2% (16/43) of patients having a bacteremia compared to 11% (8/73) in the control group, and a high prevalence of cocaine injection (81% [30/37]). Under the integrated team, higher proportions of patients had a BBV screening (90.7% [39/43] vs 64.4% [47/73]) and were offered outpatient care (81% [35/43] vs 6% [4/73]) with supported attendance. Conclusions: These results suggest a background of increasingly complicated injection behavior and subsequent infections in Scotland; however, a patient-centered, multidisciplinary care model can effectively address the health need of PWID, offering safer and more appropriate treatment pathways.