Nazima Allaudeen MD, Joyce Akwe MD, Cherinne Arundel MD, Joel C. Boggan MD, Peter Caldwell MD, Paul B. Cornia MD, Jessica Cyr MD, Erik Ehlers MD, Joel Elzweig MD, Patrick Godwin MD, Kirsha S. Gordon PhD, MS, Michelle Guidry MD, Jeydith Gutierrez MD, MPH, Daniel Heppe MD, Matthew Hoegh MD, Anand Jagannath MD, Peter Kaboli MD, MS, FACP, FHM, Michael Krug MD, James D. Laudate MD, Christine Mitchell MD, Micah Pescetto DO, Benjamin A. Rodwin MD, Matthew Ronan MD, Richard Rose MD, Meghna N. Shah MD, Andrea Smeraglio MD, Meredith Trubitt MD, Matthew Tuck MD, Jaclyn Vargas MD, Peter Yarbrough MD, Craig G. Gunderson MD
{"title":"治疗酒精使用障碍的药物和戒酒住院后的随访：一项多中心研究。","authors":"Nazima Allaudeen MD, Joyce Akwe MD, Cherinne Arundel MD, Joel C. Boggan MD, Peter Caldwell MD, Paul B. Cornia MD, Jessica Cyr MD, Erik Ehlers MD, Joel Elzweig MD, Patrick Godwin MD, Kirsha S. Gordon PhD, MS, Michelle Guidry MD, Jeydith Gutierrez MD, MPH, Daniel Heppe MD, Matthew Hoegh MD, Anand Jagannath MD, Peter Kaboli MD, MS, FACP, FHM, Michael Krug MD, James D. Laudate MD, Christine Mitchell MD, Micah Pescetto DO, Benjamin A. Rodwin MD, Matthew Ronan MD, Richard Rose MD, Meghna N. Shah MD, Andrea Smeraglio MD, Meredith Trubitt MD, Matthew Tuck MD, Jaclyn Vargas MD, Peter Yarbrough MD, Craig G. Gunderson MD","doi":"10.1002/jhm.13458","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Alcohol withdrawal is a common reason for admission to acute care hospitals. Prescription of medications for alcohol-use disorder (AUD) and close outpatient follow-up are commonly recommended, but few studies report their effects on postdischarge outcomes.</p>\n </section>\n \n <section>\n \n <h3> Objectives</h3>\n \n <p>The objective of this study is to evaluate the effects of medications for AUD and follow-up appointments on readmission and abstinence.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This retrospective cohort study evaluated veterans admitted for alcohol withdrawal to medical services at 19 Veteran Health Administration hospitals between October 1, 2018 and September 30, 2019. Factors associated with all-cause 30-day readmission and 6-month abstinence were examined using logistic regression.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Of the 594 patients included in this study, 296 (50.7%) were prescribed medications for AUD at discharge and 459 (78.5%) were discharged with follow-up appointments, including 251 (42.8%) with a substance-use clinic appointment, 191 (32.9%) with a substance-use program appointment, and 73 (12.5%) discharged to a residential program. All-cause 30-day readmission occurred for 150 patients (25.5%) and 103 (17.8%) remained abstinent at 6 months. Medications for AUD and outpatient discharge appointments were not associated with readmission or abstinence. Discharge to residential treatment program was associated with reduced 30-day readmission (adjusted odds ratio [AOR]: 0.39, 95% confidence interval [95% CI]: 0.18–0.82) and improved abstinence (AOR: 2.50, 95% CI: 1.33–4.73).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Readmission and return to heavy drinking are common for patients discharged for alcohol withdrawal. Medications for AUD were not associated with improved outcomes. The only intervention at the time of discharge that improved outcomes was discharge to residential treatment program, which was associated with decreased readmission and improved abstinence.</p>\n </section>\n </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"19 12","pages":"1122-1130"},"PeriodicalIF":2.4000,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Medications for alcohol-use disorder and follow-up after hospitalization for alcohol withdrawal: A multicenter study\",\"authors\":\"Nazima Allaudeen MD, Joyce Akwe MD, Cherinne Arundel MD, Joel C. Boggan MD, Peter Caldwell MD, Paul B. Cornia MD, Jessica Cyr MD, Erik Ehlers MD, Joel Elzweig MD, Patrick Godwin MD, Kirsha S. Gordon PhD, MS, Michelle Guidry MD, Jeydith Gutierrez MD, MPH, Daniel Heppe MD, Matthew Hoegh MD, Anand Jagannath MD, Peter Kaboli MD, MS, FACP, FHM, Michael Krug MD, James D. Laudate MD, Christine Mitchell MD, Micah Pescetto DO, Benjamin A. Rodwin MD, Matthew Ronan MD, Richard Rose MD, Meghna N. Shah MD, Andrea Smeraglio MD, Meredith Trubitt MD, Matthew Tuck MD, Jaclyn Vargas MD, Peter Yarbrough MD, Craig G. Gunderson MD\",\"doi\":\"10.1002/jhm.13458\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Alcohol withdrawal is a common reason for admission to acute care hospitals. Prescription of medications for alcohol-use disorder (AUD) and close outpatient follow-up are commonly recommended, but few studies report their effects on postdischarge outcomes.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Objectives</h3>\\n \\n <p>The objective of this study is to evaluate the effects of medications for AUD and follow-up appointments on readmission and abstinence.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>This retrospective cohort study evaluated veterans admitted for alcohol withdrawal to medical services at 19 Veteran Health Administration hospitals between October 1, 2018 and September 30, 2019. Factors associated with all-cause 30-day readmission and 6-month abstinence were examined using logistic regression.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Of the 594 patients included in this study, 296 (50.7%) were prescribed medications for AUD at discharge and 459 (78.5%) were discharged with follow-up appointments, including 251 (42.8%) with a substance-use clinic appointment, 191 (32.9%) with a substance-use program appointment, and 73 (12.5%) discharged to a residential program. All-cause 30-day readmission occurred for 150 patients (25.5%) and 103 (17.8%) remained abstinent at 6 months. Medications for AUD and outpatient discharge appointments were not associated with readmission or abstinence. Discharge to residential treatment program was associated with reduced 30-day readmission (adjusted odds ratio [AOR]: 0.39, 95% confidence interval [95% CI]: 0.18–0.82) and improved abstinence (AOR: 2.50, 95% CI: 1.33–4.73).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Readmission and return to heavy drinking are common for patients discharged for alcohol withdrawal. Medications for AUD were not associated with improved outcomes. 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Medications for alcohol-use disorder and follow-up after hospitalization for alcohol withdrawal: A multicenter study
Background
Alcohol withdrawal is a common reason for admission to acute care hospitals. Prescription of medications for alcohol-use disorder (AUD) and close outpatient follow-up are commonly recommended, but few studies report their effects on postdischarge outcomes.
Objectives
The objective of this study is to evaluate the effects of medications for AUD and follow-up appointments on readmission and abstinence.
Methods
This retrospective cohort study evaluated veterans admitted for alcohol withdrawal to medical services at 19 Veteran Health Administration hospitals between October 1, 2018 and September 30, 2019. Factors associated with all-cause 30-day readmission and 6-month abstinence were examined using logistic regression.
Results
Of the 594 patients included in this study, 296 (50.7%) were prescribed medications for AUD at discharge and 459 (78.5%) were discharged with follow-up appointments, including 251 (42.8%) with a substance-use clinic appointment, 191 (32.9%) with a substance-use program appointment, and 73 (12.5%) discharged to a residential program. All-cause 30-day readmission occurred for 150 patients (25.5%) and 103 (17.8%) remained abstinent at 6 months. Medications for AUD and outpatient discharge appointments were not associated with readmission or abstinence. Discharge to residential treatment program was associated with reduced 30-day readmission (adjusted odds ratio [AOR]: 0.39, 95% confidence interval [95% CI]: 0.18–0.82) and improved abstinence (AOR: 2.50, 95% CI: 1.33–4.73).
Conclusions
Readmission and return to heavy drinking are common for patients discharged for alcohol withdrawal. Medications for AUD were not associated with improved outcomes. The only intervention at the time of discharge that improved outcomes was discharge to residential treatment program, which was associated with decreased readmission and improved abstinence.
期刊介绍：
JHM is a peer-reviewed publication of the Society of Hospital Medicine and is published 12 times per year. JHM publishes manuscripts that address the care of hospitalized adults or children.
Broad areas of interest include (1) Treatments for common inpatient conditions; (2) Approaches to improving perioperative care; (3) Improving care for hospitalized patients with geriatric or pediatric vulnerabilities (such as mobility problems, or those with complex longitudinal care); (4) Evaluation of innovative healthcare delivery or educational models; (5) Approaches to improving the quality, safety, and value of healthcare across the acute- and postacute-continuum of care; and (6) Evaluation of policy and payment changes that affect hospital and postacute care.
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