Prevalence and Predictors of Non-Benzodiazepine Use in Patients with Alcohol Withdrawal Syndrome in United States Emergency Departments - a cross-sectional study.

Innovations in pharmacy Pub Date : 2024-08-21 eCollection Date: 2024-01-01 DOI:10.24926/iip.v15i3.6270
Kirolos Zakhary, Sophia Bruno, Caleb A Myatt, Vindya Perera, Kerolese Saleh, Jacob A Smearman, Madeline M Yuzwa, Mate M Soric, Stephanie Zampino
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Abstract

Purpose: Benzodiazepines are the mainstay treatment in Alcohol Withdrawal Syndrome (AWS), though they have the potential for abuse and cognitive side effects. Non-benzodiazepines are of growing interest for treatment of AWS; however, the prevalence of non-benzodiazepine use remains unknown. The purpose of this study is to evaluate the prevalence and predictors of non-benzodiazepine use for AWS in the Emergency Department (ED). Methods: A cross-sectional, retrospective study utilizing data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) spanning the years 2014-2020 investigated patients presenting to the ED with AWS. The primary outcome of this study is the prevalence of patients with AWS who received non-benzodiazepine treatment during their ED visit. The secondary outcome was the identification of predictor variables for non-benzodiazepine use. A multivariate logistic regression with a backward elimination approach was employed to identify predictor variables. Results: A total of 2,300 unweighted ED visits included over the study years. When weighted, this represented over 15.2 million ED visits. Across the study period, 3.1% (95% CI, 1.6-6.1%) of patients received non-benzodiazepines. Positive predictors of non-benzodiazepine use included the year 2020 compared to 2014 (OR 6.32, 95% CI, 1.39-28.73) and comorbid depression (OR 4.13, 95% CI, 1.38-12.36). Negative predictors of non-benzodiazepine use included ages 18-40 compared to ages 41-64 (OR 0.34, 95% CI, 0.13-0.91), nursing home residence compared to private residence (OR 0.02, 95% CI, 0.001-0.80), and the South compared to the Midwest region of the United States (OR 0.19, 95% CI, 0.07- 0.51). Conclusion: This study found that non-benzodiazepine use, despite being less common, is becoming more prevalent. Further research is needed to determine the optimal dosing and duration of non-benzodiazepines for AWS. Understanding the factors influencing the prescription patterns of non-benzodiazepines can contribute to informed decision-making and improve the management of AWS.

美国急诊科酒精戒断综合征患者使用非苯并二氮杂卓药物的流行率和预测因素--一项横断面研究。
目的:苯二氮卓类药物是治疗酒精戒断综合症(AWS)的主要药物,但它们有可能被滥用并产生认知副作用。非苯二氮卓类药物在治疗戒酒综合症中的作用日益受到关注;然而,非苯二氮卓类药物的使用率仍然未知。本研究旨在评估急诊科(ED)使用非苯二氮卓类药物治疗 AWS 的流行率和预测因素。研究方法这是一项横断面回顾性研究,利用了 2014-2020 年间全国医院非住院医疗护理调查 (NHAMCS) 的数据,调查了因 AWS 到急诊科就诊的患者。本研究的主要结果是在急诊室就诊期间接受非苯二氮卓治疗的 AWS 患者的患病率。次要结果是确定使用非苯二氮卓药物的预测变量。研究采用了多变量逻辑回归和反向排除法来确定预测变量。结果:在研究期间,共有 2,300 次未经加权的急诊就诊。加权后,急诊室就诊人次超过 1,520 万。在整个研究期间,3.1%(95% CI,1.6-6.1%)的患者使用了非苯二氮卓类药物。使用非苯二氮卓药物的积极预测因素包括 2020 年(与 2014 年相比)(OR 6.32,95% CI,1.39-28.73)和合并抑郁症(OR 4.13,95% CI,1.38-12.36)。使用非苯二氮卓类药物的负面预测因素包括:18-40 岁与 41-64 岁相比(OR 0.34,95% CI,0.13-0.91)、养老院住所与私人住所相比(OR 0.02,95% CI,0.001-0.80)、美国南部与中西部地区相比(OR 0.19,95% CI,0.07-0.51)。结论本研究发现,非苯二氮卓类药物的使用尽管不太常见,但却越来越普遍。需要进一步研究确定非苯二氮卓类药物治疗 AWS 的最佳剂量和持续时间。了解影响非苯二氮卓类药物处方模式的因素有助于做出明智的决策,改善对 AWS 的管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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