SRF009: Bringing Continuity to Harm Reduction: Factors Influencing Inpatient Access to Supervised Consumption Services

Avery Wynick, MD, BSc, MSc; Ginetta Salvalaggio, MD, MSc, CCFP (AM); Elaine Hyshka; Brynn Kosteniuk, MSc, BA&Sc.; Marawan Ahmed


Context: Supervised consumption services (SCS) are an important harm reduction strategy to reduce overdoses and deaths in the context of our current opioid crisis. The Royal Alexandra Hospital (RAH) in Edmonton, Canada opened the first SCS for inpatients in North America in 2018 in response to growing concerns of unsafe drug use environments for patients in hospital. Patient attendance at SCS in the community is known to be affected by many factors including daily substance use, unstable housing, and history of overdose. Given the novelty of SCS in acute care settings, there may be additional unique factors specific to hospitalization that affect access. By identifying and eliminating SCS access barriers for inpatients, continuity of harm reduction between outpatient and inpatient settings can be improved.
Objective: To identify factors unique to hospitalization that influence inpatient access of SCS.
Human Subjects Review: University of Alberta Health Research Ethics Board approval, review and guidance from a Community Advisory Group of people who use drugs.
Study Design: Retrospective case series.
Setting and Population Studied: Hospital care. Patients were admitted to the RAH and received a consultation from the Addiction Medicine Consult Team (AMCT) between April 1, 2018 and December 1, 2019 indicating intravenous drug use within six months. Forty patient charts, 20 of whom accessed the SCS, were reviewed with wide distribution among sociodemographic features by data clustering including gender, overdose history, opioid maintenance therapy, housing, and Indigenous status.
Intervention/Instrument: Not applicable.
Main Outcome Measures: Attending the SCS at least once as the main outcome measure between groups.
Anticipated Results: We predict that factors such as length of stay, mobility restrictions, and isolation precautions will impact SCS access. We will share findings with both community and hospital care teams to support SCS-eligible patients undergoing transitions between hospital- and community-based care settings.
Conclusions: Factors unique to hospitalization may influence the access of SCS for inpatients. Identification and removal of these barriers can increase access for inpatients.
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Jack 11/21/2020

harm reduction is so important. thank you for the work you are doing. and thank you for sharing this with NAPCRG.

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