The journey of patients with problematic alcohol use and at risk of Korsakoff Syndrome: A PRISMA scoping review.

Abstract

Objective: Patients with problematic alcohol use and increased risk of Korsakoff Syndrome (KS) often do not receive timely or appropriate care. Professionals experience difficulties in diagnosing, treating, and guiding this target group. This scoping review aims to map the patient journey of individuals with problematic alcohol use who may be at risk of alcohol-related brain damage or KS.

Methods: This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The search strategy included MeSH and title/abstract terms related to "problematic alcohol use", "Wernicke encephalopathy", "patient journey", and "experiences/perspectives". CINAHL, MedLine, and Cochrane were searched (April 18th, 2025) for English and Dutch publications (2015-2025), without restrictions on article type. Records were deduplicated and imported into Rayyan. Two independent reviewers screened titles/abstracts. Full texts were screened when inclusion criteria were met. Discrepancies were resolved through consensus. Key findings were extracted.

Results: The search yielded 3171 records. 59 articles were included. Literature suggests that patient journeys among individuals with problematic alcohol use who may be at increased risk of KS are heterogeneous and often involve cycles of hospitalization, detoxification, community care, and relapse-related admissions. Commonly reported barriers included stigma, fragmented care pathways, waiting lists, and limited recognition of alcohol-related brain damage, Wernicke Encephalopathy, and KS. Several studies reported traumatic life events as potential antecedents to problematic alcohol use. Some patients at risk of KS or living with KS, may exhibit care-avoidant behaviour and require non-stigmatizing, personalized, and integrated care to improve engagement.

Conclusions: The literature suggests that improving knowledge, reducing fragmentation, and strengthening multidisciplinary collaboration may contribute to improving the patient journey. Literature also indicates that integrated multidisciplinary and person-centred approaches may improve recognition, coordination of care and support for individuals at risk of KS. However, the evidence base remains heterogeneous and largely indirect. Longitudinal and intervention studies are needed to evaluate effectiveness and establish causal relationships.