Abstract：
Background: Rates of acute care use, including hospital admission and readmission, are high for people who misuse substances. Hospitalization provides a valuable opportunity for intervention, but addiction treatment is often not addressed in the inpatient setting. Addiction consult services are a novel intervention intended to change hospital practices.Objectives: Comprehensively summarize outcomes (quantitative and qualitative) associated with inpatient addiction consult services.Methods: English-language searches of: Medline, CINAHL, Embase, The Cochrane Database of Systematic Reviews, PubMed, PsychInfo and Google Scholar were conducted from 2000 to November 2022. Studies reporting outcomes associated with addiction specialist consultation in the hospital setting were included. Four independent reviewers screened abstracts, and three reviewers screened full-text articles.Results: A total of 1,113 results underwent title and abstract screening and 43 studies were included. Outcomes associated with addiction specialist consultation were heterogeneous. Quantitative clinical outcomes focused on pharmacotherapy, healthcare utilization, and outpatient follow-up. Consultation improved rates of pharmacotherapy use, but had inconsistent effects on health care use, and overall follow-up rates were low. Consultation was associated with reduced overdose rates and 90-day mortality. Additional outcomes related to medical learners\' educational achievements and qualitative results described positive effects on trainees, healthcare providers, and patients seen by specialized consult services. Access to dedicated providers improved experiences in hospitals for both people who misuse substances and their healthcare providers.Conclusion: Addiction specialist consultations are related to several clinical metrics, but some outcomes (e.g. pharmacotherapy initiation) may be more amenable to intervention than others (healthcare utilization). Qualitative findings provide important context for quantitative clinical results.
摘要：
背景：急性护理使用率，包括入院和再入院，对于滥用物质的人来说是很高的。住院为干预提供了宝贵的机会，但是在住院患者中通常不会解决成瘾治疗问题。成瘾咨询服务是一种新颖的干预措施，旨在改变医院的做法。目标：全面总结与住院成瘾咨询服务相关的结果（定量和定性）。方法：英语搜索：Medline，CINAHL,Embase,Cochrane系统评价数据库，PubMed,PsychInfo和GoogleScholar于2000年至2022年11月进行。包括报告与医院环境中成瘾专家咨询相关结果的研究。四位独立审稿人筛选了摘要，三位审稿人筛选了全文文章。结果：共有1,113项结果进行了标题和摘要筛选，纳入了43项研究。与成瘾专家咨询相关的结果是异质的。定量临床结果集中在药物治疗上，医疗保健利用，和门诊随访。咨询提高了药物治疗的使用率，但对医疗保健使用的影响不一致，总体随访率较低。会诊与过量用药率和90天死亡率降低相关。与医学学习者的教育成就和定性结果相关的其他结果描述了对受训者的积极影响，医疗保健提供者，以及由专业咨询服务看到的患者。获得专门的提供者改善了滥用药物的人及其医疗保健提供者在医院的体验。结论：成瘾专家咨询与几种临床指标有关，但某些结局(例如药物治疗开始)可能比其他结局(医疗保健利用)更适合干预.定性发现为定量临床结果提供了重要的背景。
