Magdalena Harris is Professor of Inclusion Health Sociology at the London School of Hygiene and Tropical Medicine. Her research centres on improving harm reduction and health care access for socially excluded populations of people who use drugs. She works closely with affected communities to co-produce evidence that informs practice and policy, advancing approaches that prioritise lived experience and equity.

Abstract

Improving hospital opiate substitution therapy

iHOST is an NIHR funded research project aiming to improve opioid withdrawal management in NHS hospitals. The iHOST intervention comprises: a clinical guideline, hospital provider training, a patient advocacy card, a helpline and a champion role. This presentation will focus on the development and evaluation of the clinical guideline, which has been in place at a central London hospital since November 2022 and at Leeds and Stoke hospitals since July 2024. Magdalena will present qualitative process evaluation and patient record audit data from the London hospital site, the latter demonstrating a reduction in time to methadone administration after iHOST implementation, with no evidence of increased risk of opioid toxicity. Qualitative interview data indicate positive patient and provider experiences of the intervention, however rates of discharge against medical advice remain high. Magdalena will close with and invite reflection on, the complexities of discharge against medical advice as an outcome measure and overview next steps for intervention scale up.