Maine Medical Center, Medical Education, Maine Medical Center Research Institute, Center for Outcomes Research & Evaluation
Humans, Manipulation, Osteopathic, Inpatients, Substance-Related Disorders
OBJECTIVES: Inpatient hospitalization can often offer an opportunity to initiate treatment and preventive care that otherwise would be lost. At our hospital, which is a tertiary care teaching hospital in a region where injection drug use is rising, a multidisciplinary “IMAT” (integrated medication assisted treatment) team is available to facilitate substance use disorder treatment and services. In addition, consultation services for osteopathic manipulative medicine (OMM) are available. Osteopathic manipulative treatment (OMT) can play an important role in the overall healing and well-being of an individual. This non-invasive, hands on approach can improve patient comfort, promote recovery, and potentially reduce length of stay in hospitalized patients. The objective in this analysis was to describe demographics and health characteristics of IMAT patients who received a consultation request for OMT. We also aimed to identify areas of need and opportunities for practice improvement in the area of hospital based osteopathic manipulative medicine to treat patients with substance use disorders.
METHODS: A retrospective chart review was conducted on inpatients at a tertiary care hospital in Portland Maine and included hospitalized patients seen by the IMAT consult service between 7/1/2016 and 6/30/2017. Data was directly abstracted from electronic medical records. Descriptive analysis was performed using Microsoft Excel and Stata IC64.
RESULTS: A total of 145 patients with substance use disorder were seen by the IMAT service during their hospitalization. Thirty four (23.4%) patients received an OMM consult and subsequent treatment. Musculoskeletal complaint of some type was the primary reason for consultation request with back pain being the most frequent (35%). Among those seen, 55% had one visit, 20.6% had 2, and 14.7% had 3 visits. Only one patient had more than 3 visits. There were 17 males and 17 females, 2 of whom were pregnant. Sixty seven percent were hospitalized for infectious process, 44% required some type of surgery to treat an infectious complication. Thirty six percent of patients were seen by the acute pain management consult service; 34(65%) of those did not receive OMM consults. Regarding medications for opiate use disorder (MOUD), of those seen for OMT, 44% were on MOUD prior to admission, 73% were planning MOUD upon discharge.
CONCLUSIONS: Our study showed that OMM consultation requests were somewhat low. Given the prevalence of musculoskeletal complaints in patients seen by the OMM service, these results suggest that OMT may be under-utilized in those patients who are hospitalized for consequences related to their drug use and may have concurrent pain. Additional research is warranted to determine if OMT helps reduce length of stay, facilitate treatment for addiction, and improve patient outcomes.
Cleary, Alisa; Nenninger, E. Katherine; Keller, David; and Thakarar, Kinna, "Osteopathic Manipulative Medicine may help hospitalized patients with substance use disorder." (2020). Costas T. Lambrew Research Retreat 2020. 64.