Internal Medicine · Infectious Disease ·
Patients Describe Barriers and Support During Hospitalization for Injection-Related Infections
In qualitative interviews, 30 people with opioid use disorder and serious injection-related infections described experiences in hospital and during discharge planning. Participants identified stigma, withdrawal and pain management as factors shaping hospital care, alongside the value of empathy and shared decision-making.
- Stigma, withdrawal and pain concerns delayed hospital presentation.
- Empathy and symptom management shaped positive inpatient experiences.
- Participants valued discharge planning and shared decision-making.
- Qualitative findings do not establish intervention effectiveness.
Serious injection-related infections can lead to prolonged hospitalizations, and efforts to connect patients with medications for opioid use disorder (MOUD) during admission have expanded. Researchers conducted semi-structured interviews with 30 people with opioid use disorder who had received a serious injection-related infection diagnosis over a three-year period ending in 2022. Participants were recruited through an inpatient service, a harm reduction program and telephone outreach. Most were male (19), white (21) and housed (20); 10 had endocarditis and nine had osteomyelitis.
Four themes emerged: concerns about stigma, withdrawal and pain control contributed to delayed hospital presentation; empathy and adequate management of pain and withdrawal shaped positive experiences; withdrawal and conflict with staff contributed to in-hospital substance use and patient-directed discharge; and discharge planning was valued, though participants called for consistent protocols and shared decision-making.
The authors suggest MOUD and shared decision-making as practical approaches to improving care. The findings offer patient perspectives that may inform inpatient care and transitions, but this small qualitative study did not test whether specific interventions improve outcomes. Participants were recruited from Boston-area settings, which may also limit how broadly the findings apply.
In practice
For clinicians caring for people with opioid use disorder hospitalized with serious injection-related infections, participants identified stigma, unmanaged withdrawal and pain, and conflict with staff as factors associated with delayed presentation, in-hospital substance use and patient-directed discharge. Empathy, adequate symptom management, MOUD and shared discharge decisions are practical areas for care planning, according to the authors. These are qualitative findings from 30 participants recruited in Boston-area settings; the study did not test whether these approaches improve outcomes or establish a protocol that should be adopted.
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Journal of General Internal Medicine: “They’ve Come a Long Way”: A Qualitative Study of Hospitalization Experiences for Serious Injection-Related Infections in Boston, MA ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.