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Symptom-Triggered Detoxification Using the Alcohol-Withdrawal-Scale Reduces Risks and Healthcare Costs.
- Source :
-
Alcohol and alcoholism (Oxford, Oxfordshire) [Alcohol Alcohol] 2018 Jan 01; Vol. 53 (1), pp. 71-77. - Publication Year :
- 2018
-
Abstract
- Aims: As there are only a few existing experimental studies on symptom-triggered therapy for patients with alcohol withdrawal, we investigated the effectiveness of symptom-triggered detoxification regarding the use and dosage of benzodiazepine and withdrawal complications in a naturalistic clinical setting of a specialized treatment center for alcohol use disorder.<br />Methods: In total, 301 charts of patients who entered residential treatment for alcohol withdrawal were included in the retrospective analysis. Charts of 176 patients treated with the Alcohol Withdrawal-Scale (AWS) were compared to the charts of 125 patients treated with treatment as usual (TAU) before the implementation of AWS. Sociodemographical and clinical variables, previous detoxifications and complications, duration of treatment, use and dose of benzodiazepine and other withdrawal medication, complications and premature discontinuation of treatment were abstracted from the patients' medical records.<br />Results: The two groups did not differ in any demographical or clinical variables measured upon treatment admission. The total percentage of patients being treated with benzodiazepines during detoxification decreased from 78.4 to 38.6% after the implementation of the AWS. The implementation of the AWS significantly reduced the duration of the acute detoxification from 136 to 66 h, and the use, duration and dose of benzodiazepine by nearly two-thirds while complications and treatment discontinuation remained unvaryingly. Healthcare costs for detoxification were reduced by half per patient.<br />Conclusions: The findings indicate that symptom-triggered treatment for alcohol withdrawal is safe and effective in a naturalistic clinical setting and significantly reduces healthcare costs and the risk for overmedicating patients.<br /> (© The Author 2017. Medical Council on Alcohol and Oxford University Press. All rights reserved.)
- Subjects :
- Adolescent
Adult
Aged
Alcohol Withdrawal Delirium economics
Alcoholism economics
Benzodiazepines therapeutic use
Cost Control
Female
Humans
Hypnotics and Sedatives therapeutic use
Kaplan-Meier Estimate
Male
Medical Overuse prevention & control
Middle Aged
Retrospective Studies
Risk Reduction Behavior
Socioeconomic Factors
Young Adult
Alcohol Withdrawal Delirium diagnosis
Alcohol Withdrawal Delirium psychology
Alcoholism psychology
Alcoholism rehabilitation
Health Care Costs
Subjects
Details
- Language :
- English
- ISSN :
- 1464-3502
- Volume :
- 53
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Alcohol and alcoholism (Oxford, Oxfordshire)
- Publication Type :
- Academic Journal
- Accession number :
- 29281047
- Full Text :
- https://doi.org/10.1093/alcalc/agx080