BRIDGE (opioid use disorder)
Trial question
What is the effect of a bridge clinic referrals in inpatients with opioid use disorder?
Study design
Single center
Open label
RCT
Population
Characteristics of study participants
42.0% female
58.0% male
N = 335
335 patients (141 female, 194 male).
Inclusion criteria: hospitalized adults with opioid use disorder considered for medications without a fixed outpatient plan.
Key exclusion criteria: addiction consultation services deemed ineligible for referral to outpatient bridge clinic.
Interventions
N=167 bridge clinic referral (multispecialty clinic with addiction consult wraparound services co-located near inpatient services).
N=168 usual care referral (nonspecialty, hospital-based social worker team).
Primary outcome
Median length of hospital stay
5.9 days
5.7 days
5.9 days
4.4 days
3.0 days
1.5 days
0.0 days
Bridge clinic
referral
Usual care
referral
No significant
difference ↔
No significant difference in median length of hospital stay (5.9 days vs. 5.7 days; OR 0.94, 95% CI 0.65 to 1.37).
Secondary outcomes
Borderline significant decrease in median hospital-free and emergency department-free days (112 days vs. 112 days; OR 0.61, 95% CI 0.39 to 0.95).
Borderline significant increase in ≥ 1 readmission or emergency department visit (41.3% vs. 31%; OR 1.61, 95% CI 1.01 to 2.57).
No significant difference in death (1.2% vs. 2.4%; OR 0.48, 95% CI 0.08 to 2.72).
Conclusion
In hospitalized adults with opioid use disorder considered for medications without a fixed outpatient plan, bridge clinic referral was not superior to usual care referral with respect to median length of hospital stay.
Reference
David Marcovitz, Mary Lynn Dear, Rebecca Donald et al. Effect of a Co-Located Bridging Recovery Initiative on Hospital Length of Stay Among Patients With Opioid Use Disorder The BRIDGE Randomized Clinical Trial. JAMA Netw Open. 2024 Feb 5;7(2):e2356430.
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