Impact of a multidisciplinary endocarditis evaluation team for opioid use associated infective endocarditis

BACKGROUND: Infective endocarditis (IE) related to opioid use disorder (OUD) and injection substance use is on the rise. Multidisciplinary care is recommended for individuals with substance-related IE, but little is known about the impact of this care. OBJECTIVES: A retrospective cohort study to evaluate the impact of a multidisciplinary endocarditis evaluation team (MEET) on outcomes for patients with IE and specifically OUD-related IE. The MEET is a clinical team from multiple specialities that collaboratively facilitates optimal hospital-based treatment, including addiction-related treatment. METHODS: The study compares a historical control group of hospitalized adults with OUD and OUD-related IE who did not receive the MEET intervention (treatment as usual [TAU] group) with a group of hospitalized adults with OUD and OUD-related IE who received the MEET intervention. The primary outcome is receipt of medication for OUD (MOUD) at hospital discharge. Secondary outcomes are receipt of OUD treatment referral, 30-day ED visits, 30-day hospital re-admission, all-cause mortality, recurrence of IE, and repeat IE-related surgery. RESULTS: Nearly all patients in the MEET group (n = 68) were discharged on MOUD compared with the TAU group (n = 58) (98.5% vs. 56.9%) and received a referral for OUD treatment (97.1% vs. 74.1%). We were unable to detect a difference in 30-day ED visits and hospital readmissions, all-cause mortality, recurrent IE, and repeat IE-related surgery. CONCLUSIONS: A multidisciplinary intervention was associated with improved OUD-related outcomes. No change was observed in health care utilization, all-cause mortality, or other IE-related outcomes.