“Aims and hypothesis
To identify and manage the medical comorbidities of patients admitted to an inpatient detox ward.

Background
Scotland had the highest per capita number of drug-related deaths in Europe in 2018 while alcohol continues to be a major contributor to premature deaths and poor health among the Scottish population. With an aging cohort of substance users in Scotland, the impact of medical comorbidities in contributing to these excess deaths has been acknowledged. Poor access to health care is also recognised as an important issue for marginalised populations.

Methods
Working in the Kershaw Unit (a 15-bed inpatient detox ward) we used primary care guidelines to identify areas of health where patients had unmet needs and then developed our own pathways to manage these.

Results
We identified several areas where patients often have unmet health needs that would typically be diagnosed and managed in a primary care setting. These include hypertension, type 2 diabetes and COPD. Uptake of national screening programmes was also recognised to be low. We developed a new admission document prompting medical staff to screen for these conditions. We are also undertaking a capacity building project that will enable spirometry and cervical smear tests to be undertaken in the unit.

Conclusions
Creating a new admission document has increased awareness of investigating medical comorbidities in the unit. However an ongoing part of this project is creating sustainability by embedding this awareness into standard ward practice.

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