# Effectiveness of an Embedded Infectious Disease Screening, Treatment, and Prevention Intervention Within an Inpatient Substance Use Treatment Program

## TL;DR

Adding infectious disease screening to substance use treatment programs increases testing rates and helps patients get preventive care and treatment.

## Contribution

This study demonstrates that embedding infectious disease screening in inpatient substance use treatment programs significantly increases screening uptake and treatment initiation.

## Key findings

- Screening for infectious diseases increased from 60.2% to 90.8% during the intervention period.
- HAV and HBV vaccination rates increased from 0% to 58% and 71%, respectively.
- HCV treatment initiation increased from 0% to 36.8% within two weeks of testing.

## Abstract

People with substance use disorders (SUDs) are at higher risk for infectious diseases (IDs). Co-locating ID screening services within inpatient SUD treatment programs may decrease barriers to care; however, the impact of such screening has not been evaluated.

We conducted an effectiveness study evaluating comprehensive ID screening within an 18-bed inpatient SUD program. During usual care (September 2021–June 2022), ID screening was completed at the discretion of the admitting psychiatrist. During the intervention (September 2022–June 2023), an ID-trained nurse met with patients to support completion of screening for HIV, viral hepatitis (hepatitis A [HAV], B [HBV], and C [HCV]), latent tuberculosis [LTBI], and sexually transmitted infections [STI]. Hepatitis vaccinations, HIV preexposure prophylaxis, and/or ID treatments were offered during admission.

Demographics were similar between the groups (n = 261, usual care; n = 207, intervention). Screening for ≥1 ID increased significantly during the intervention (60.2% vs 90.8%, P < .001), with the greatest increases in HAV (6.1% vs 90.3%, P < .001), HBV (8.8% vs 91.3%, P < .001), and LTBI (1.9% vs 67.8%, P < .001). HAV and HBV vaccinations increased from 0% to 58% and 71%, respectively. HCV viremia was identified in 15 usual care and 19 intervention patients, of whom 0% and 36.8% initiated direct-acting antiviral therapy within 2 weeks of testing. STIs were identified in 9.2% and 13.5% (P = .09) of the patients in the usual care and intervention groups.

Comprehensive ID screening within inpatient SUD programs can increase uptake of testing and facilitate low-barrier delivery of preventive and therapeutic treatment.

Embedded infectious disease screening in an inpatient substance use disorder treatment program significantly increases screening frequency and can facilitate timely initiation of treatment and preventive measures, improving health care delivery for patients.

Graphical AbstractThis graphical abstract is also available at Tidbit: https://tidbitapp.io/tidbits/real-world-effectiveness-of-an-embedded-infectious-disease-screening-treatment-and-prevention-program-within-an-inpatient-substance-use-treatment-program

This graphical abstract is also available at Tidbit: https://tidbitapp.io/tidbits/real-world-effectiveness-of-an-embedded-infectious-disease-screening-treatment-and-prevention-program-within-an-inpatient-substance-use-treatment-program