Clinical Scorecard: Evaluating the Impact of Integrated Infectious Disease Screening and Management within an Inpatient Program for Substance Use Disorders

At a Glance

Key Highlights

• Integrated ID screening increased testing uptake from 60.2% to 90.8%, with significant rises in hepatitis A, B, and latent tuberculosis screening.
• Hepatitis A and B vaccination rates increased from 0% to 58% and 71%, respectively, during the intervention.
• Direct-acting antiviral therapy initiation for hepatitis C viremia improved from 0% to 36.8% within 2 weeks of testing.

Guideline-Based Recommendations

Diagnosis

• Regular screening for HIV, viral hepatitis (HAV, HBV, HCV), latent tuberculosis infection, and sexually transmitted infections among people with SUD.
• Screening should be systematic and integrated within SUD treatment settings to overcome patient- and provider-level barriers.

Management

• Offer hepatitis vaccinations (HAV, HBV), HIV preexposure prophylaxis, and infectious disease treatments during inpatient admission.
• Provide low-barrier, co-located infectious disease services within SUD treatment programs.

Monitoring & Follow-up

• Track screening uptake rates and treatment initiation timelines for infectious diseases among inpatient SUD populations.
• Monitor vaccination coverage and linkage to care for identified infections.

Risks

• Missed screening opportunities contribute to ongoing community transmission and delayed treatment.
• Low baseline screening rates highlight risk of undiagnosed infections in SUD populations.

Patient & Prescribing Data

Adults admitted for inpatient substance use disorder treatment

Integrated screening increased initiation of direct-acting antivirals for HCV and uptake of hepatitis vaccinations, demonstrating improved preventive and therapeutic care delivery.

Clinical Best Practices

• Embed infectious disease-trained nursing staff within inpatient SUD programs to facilitate comprehensive screening.
• Implement systematic protocols for infectious disease testing at admission rather than relying on provider discretion.
• Provide on-site vaccination and treatment services to reduce barriers and improve timely care.
• Use data to monitor screening and treatment outcomes to guide quality improvement.

References

• Real-world effectiveness of an embedded infectious disease screening-treatment and prevention program within an inpatient substance use treatment program