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Medications for alcohol-use disorder and follow-up after hospitalization for alcohol withdrawal: A multicenter study.

Authors :
Allaudeen N
Akwe J
Arundel C
Boggan JC
Caldwell P
Cornia PB
Cyr J
Ehlers E
Elzweig J
Godwin P
Gordon KS
Guidry M
Gutierrez J
Heppe D
Hoegh M
Jagannath A
Kaboli P
Krug M
Laudate JD
Mitchell C
Pescetto M
Rodwin BA
Ronan M
Rose R
Shah MN
Smeraglio A
Trubitt M
Tuck M
Vargas J
Yarbrough P
Gunderson CG
Source :
Journal of hospital medicine [J Hosp Med] 2024 Jul 19. Date of Electronic Publication: 2024 Jul 19.
Publication Year :
2024
Publisher :
Ahead of Print

Abstract

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.<br />Objectives: The objective of this study is to evaluate the effects of medications for AUD and follow-up appointments on readmission and abstinence.<br />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.<br />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).<br />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.<br /> (Published 2024. This article is a US Government work and is in the public domain in the USA.)

Details

Language :
English
ISSN :
1553-5606
Database :
MEDLINE
Journal :
Journal of hospital medicine
Publication Type :
Academic Journal
Accession number :
39031461
Full Text :
https://doi.org/10.1002/jhm.13458