Prospective Recovery Assessment to Improve SuccEss (PRAISE) study: Lessons learned in assessing patient-important outcomes in patients with substance use disorder

Introduction: Inpatient substance use services (SUS) offer evidence-based, trauma-informed care for people who use drugs (PWUD). Given that SUS are relatively new and the needs of PWUD evolve, timely research to evaluate and shape these services is important. This pilot aims to describe the patient population seen by our institution's SUS, explore patient-important outcomes during hospitalization, and assess the feasibility and acceptability of a prospective research design. Methods: We conducted a prospective observational assessment of patients admitted to a tertiary care hospital seen in consultation by the SUS between October 2021 and August 2022. Enrolled participants completed admission and discharge assessments including demographics, substance use, hospital experience, psychological batteries, and study feasibility. Results: In total, 21 patients were enrolled. Substances used in the past 3 months included opioids (76%), cocaine (29%), other stimulants (48%), and sedatives (48%). Thirteen patients (62%) reported injection use and 10 (48%) past-year overdose. Enrollment was impacted by recruitment barriers, largely secondary to systems challenges including the COVID-19 pandemic. The prospective design captured high levels of withdrawal symptoms, cravings, depression, and anxiety; high motivation to change, but lower confidence in change; and positive perceptions of safety, respect, and support in the hospital. Participants rated the assessments as simple, fairly compensated, and acceptable. Discussion: Although enrollment of hospitalized patients with high-severity substance use disorders was challenging, this pilot study suggested that a battery of brief psychometrically validated measures of patient-important outcomes was feasible and highly tolerable for patients, supporting the potential for prospective data collection or integration of these measures into care.