Impact of Integrated Infectious Disease Screening in Inpatient SUD Treatment

Overview

Integrating comprehensive infectious disease (ID) screening within an inpatient substance use disorder (SUD) program significantly increased testing rates for HIV, viral hepatitis, latent tuberculosis, and sexually transmitted infections. The intervention also improved vaccination uptake and facilitated timely initiation of antiviral therapy for hepatitis C virus (HCV) infection.

Background

People with substance use disorders are at elevated risk for infectious diseases such as HIV, viral hepatitis, latent tuberculosis infection, and sexually transmitted infections. Despite recommendations for regular screening, rates remain low due to patient and provider barriers. Integrated screening approaches within SUD treatment settings have shown promise but have not been fully evaluated in inpatient programs. This study assessed the effectiveness of embedding comprehensive ID screening, prevention, and treatment services within an 18-bed inpatient SUD program.

Data Highlights

Key Findings

• Screening for at least one infectious disease increased from 60.2% to 90.8% with the intervention (P < .001).
• Screening rates for hepatitis A, hepatitis B, and latent tuberculosis infection increased dramatically during the intervention period.
• Hepatitis A and B vaccination uptake increased from 0% to 58% and 71%, respectively, after intervention implementation.
• Among patients with HCV viremia, 36.8% initiated direct-acting antiviral therapy within two weeks during the intervention, compared to 0% in usual care.
• Identification of sexually transmitted infections increased from 9.2% to 13.5%, though this change was not statistically significant (P = .09).

Clinical Implications

Embedding infectious disease screening and management within inpatient SUD programs can substantially improve testing coverage and facilitate timely preventive and therapeutic interventions. This integrated approach reduces barriers to care and may help address ongoing transmission and morbidity associated with infectious diseases in this high-risk population.

Conclusion

Comprehensive infectious disease screening integrated into inpatient substance use treatment programs enhances detection, prevention, and treatment uptake, representing a promising strategy to improve health outcomes among people with substance use disorders.

References

1. Evaluating the Impact of Integrated Infectious Disease Screening and Management within an Inpatient Program for Substance Use Disorders