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Racial Disparities in Medication for Opioid Use Disorder Initiation and Discontinuation During Trauma Hospitalization
Hannah Bard, B.A.
1, Samantha Watts, B.S.
1, Gurkeerat Singh, B.S.
1, Robert Koegel, M.S.
1, Anne K. Buck, M.S.
2,
3, Tracey Dechert, M.D., F.A.C.S.
3, Lisa Allee, MSW, LICSW
1,
3
1Boston University Chobanian & Avedisian School of Medicine, Boston, MA, 2Boston University School of Public Health, Boston, MA, 3Boston Medical Center, Department of Trauma and Acute Care Surgery, Boston, MA
Introduction: Traumatic injury occurs more frequently in those with opioid use disorder (OUD) and presents an opportunity for initiating medications for OUD (MOUD) among those not on MOUD at admission. It was hypothesized that disparities in MOUD usage at admission and discharge would vary by demographic subgroup.
Methods: Retrospective cohort study of 316 patients admitted to Boston Medical Center from 1/1/2017 - 12/31/2022 identified patients with a prior diagnosis of OUD. MOUD status at admission as well as initiation, continuation, or discontinuation of MOUD prior to discharge was observed by racial group.
Results: Twenty nine percent of admitted Black patients were already on an MOUD compared to 58% of White patients. Among those not on MOUD at admission, 20% of Black and 30% of White patients initiated MOUD during hospitalization. Of those on MOUD at admission, 22% of Black and 13% of White patients discontinued MOUD during hospitalization.
Conclusion: Black patients with OUD were less likely to be on an MOUD upon admission or to be initiated on one during hospitalization. They were also more likely to discontinue if admitted on an MOUD. The stark difference in these results highlights a disparity in care for a vulnerable population. While there may be confounders in the data, there is a large opportunity to promote initiation and continued maintenance of MOUD in all patients regardless of race.
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