Background:Treatment for opioid use disorder (OUD) is highly effective, yet it remains dramatically underutilized.\nIndividuals with OUD have disproportionately high rates of hospitalization and low rates of addiction treatment. Hospital-\nbased addiction consult services offer a potential solution by using multidisciplinary teams to evaluate patients,\ninitiate medication for addiction treatment (MAT) in the hospital, and connect patients to post-discharge care. We\nare studying the effectiveness of an addiction consult model [Consult for Addiction Treatment and Care in Hospitals\n(CATCH)] as a strategy for engaging patients with OUD in treatment as the program rolls out in the largest municipal\nhospital system in the US. The primary aim is to evaluate the effectiveness of CATCH in increasing post-discharge initiation\nand engagement in MAT. Secondary aims are to assess treatment retention, frequency of acute care utilization\nand overdose deaths and their associated costs, and implementation outcomes.\nMethods:A pragmatic trial at six hospitals, conducted in collaboration with the municipal hospital system and\ndepartment of health, will be implemented to study the CATCH intervention. Guided by the RE-AIM evaluation\nframework, this hybrid effectiveness-implementation study (Type 1) focuses primarily on effectiveness and also measures\nimplementation outcomes to inform the interventionâ??s adoption and sustainability. A stepped-wedge cluster\nrandomized trial design will determine the impact of CATCH on treatment outcomes in comparison to usual care\nfor a control period, followed by a 12-month intervention period and a 6- to 18-month maintenance period at each\nhospital. A mixed methods approach will primarily utilize administrative data to measure outcomes, while interviews\nand focus groups with staff and patients will provide additional information on implementation fidelity and barriers to\ndelivering MAT to patients with OUD.\nDiscussion:Because of their great potential to reduce the negative health and economic consequences of\nuntreated OUD, addiction consult models are proliferating in response to the opioid epidemic, despite the absence of\na strong evidence base. This study will provide the first known rigorous evaluation of an addiction consult model in a\nlarge multi-site trial and promises to generate knowledge that can rapidly transform practice and inform the potential\nfor widespread dissemination of these services
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