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Improving care for patients with Alcohol Use Disorder: A role for Community Paramedicine Programs
Introduction
Paramedicine is evolving as strained health systems develop creative ways to meet growing healthcare needs. Community paramedicine (CP) is a branch of paramedicine that is expanding, allowing paramedics to provide community interventions. CP programs have a unique role in supporting marginalized patients, like those with alcohol use disorder (AUD), as these patients have poor access to community supports and significant disease burden. CP interventions for patients with AUD can help improve their health and reduce emergency department (ED) use, freeing resources for our strained emergency care system.
Objective
To determine the impact of a regional centre CP program on patients with AUD.
Methods
Patients enrolled in the Moose Jaw CP program with a diagnosis of AUD were identified. Patient demographics, program usage, and number of ED diversions were collected. Retrospective chart reviews were conducted to determine ED visits by these patients from one year pre-implementation of the CP program thru December 2023. Data was analyzed using descriptive statistics (mean +/- SE).
Results
Between 2021-2023, 815 patients accessed the CP program. Patients with AUD accounted for 2149 of the total 4640 patient interactions with the CP program (43.6%). Complete chart review and analysis was completed on 102 of the patients with AUD. The average age was 43.21 +/- 1.50 years with 54 (52.9%) males and 48 (47.1%) females. These patients had a total of 1769 interactions with the CP program (38% of all interactions) and mean CP visits were 17.34 +/- 2.86 per patient. There was a total of 504 ED visits with 5.2 +/- 0.60 ED visits per patient. The CP program identified 507 ED diversions because of CP interactions.
Conclusion
Since its inception, this regional CP program has enrolled multiple patients with AUD. These AUD patients have accounted for a disproportionally large amount of CP interactions suggesting that patients with AUD have unmet community needs which may contribute to their frequent ED use. Community paramedics provide an impactful point of contact for this patient population. As CP programs continue to grow, they will be able to provide increasing services that further address the needs of marginalized patient populations.
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