Fig 1.
By identifying the primary reasons for low prescription rate of MATs for AUD, we were able to target a key hospital resource to resolve several of the major failure points.
Fig 2.
Pharmacy-based workflow for MAT of AUD.
We designed an evidence-based workflow to guide the process followed by inpatient pharmacy. A pharmacist would follow the pathway above to identify the appropriate management. They then notified a medicine team member of their recommendations for AUD medications prior to patient discharge. *Recent is defined as short-acting opioids in the past 7 days, extended-release opioids in the past 10 days, and long-acting opioids in the past 14 days. **Inform the primary team that if there are concerns for side effects, can start at 25 mg QDAY for 3 days, then titrate to 50 mg QDAY. ‡Can recommend titration goals to the primary physician with caution for excess sedation. †Recommend to start medication once detoxification/withdrawal is done. CIWA: Clinical Institute Withdrawal Assessment; AST: aspartate transaminase; ALT: alanine transaminase; OUD: opioid use disorder; QDAY: daily; QHS: nightly; TID: three times daily; BID two time daily; AUD: alcohol use disorder; CrCl: creatinine clearance.
Table 1.
Patient baseline characteristics.
Fig 3.
Rates of individual medications prescribed at discharge as well as total MATs prescribed significantly improved with our pharmacy-led intervention. ** for p-value < 0.001.
Table 2.
Pre- and post-intervention MAT prescription rates.