Premium
Evaluation of a Novel Protocol for Assessment and Treatment of Alcohol Withdrawal Syndrome in Psychiatric Inpatients
Author(s) -
Butterfield Michael,
ThorneHumphrey Lucas,
Suzuki Joji,
Herschenhous Nicole
Publication year - 2020
Publication title -
the american journal on addictions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.997
H-Index - 76
eISSN - 1521-0391
pISSN - 1055-0496
DOI - 10.1111/ajad.13058
Subject(s) - medicine , interquartile range , benzodiazepine , alcohol withdrawal syndrome , incidence (geometry) , protocol (science) , retrospective cohort study , alcohol use disorder , adverse effect , cumulative incidence , population , psychiatry , cohort , alcohol , biochemistry , chemistry , physics , receptor , alternative medicine , environmental health , pathology , optics
Background and Objectives Despite the high incidence of alcohol withdrawal syndrome (AWS) in psychiatric inpatients, standardized methods for assessing and treating AWS have been studied only once before in this population. We evaluated a novel AWS assessment and treatment protocol designed for psychiatric inpatients. Methods This retrospective cohort study evaluated outcomes before and after implementation of the protocol. We collected consecutive data on patients (N = 138) admitted to inpatient psychiatric units at a single center. Participants were patients admitted for nonsubstance‐related psychiatric reasons, who were also at risk for developing AWS. Those who developed AWS were treated with either (a) treatment as usual (TAU) or (b) a novel standardized protocol. The primary outcome was duration of benzodiazepine treatment for symptoms of alcohol withdrawal. Secondary outcomes included cumulative benzodiazepine dose administered, treatment duration, and incidence of complications. Results Of 138 participants, 83 received TAU and 55 were assessed and treated with the novel protocol. Median duration of benzodiazepine treatment following protocol implementation was 19.7 hours (interquartile range [IQR], 0‐46) prior to implementation (TAU) and 0 hours (IQR, 0‐15) following protocol implementation (protocol group) ( P < .0001). Median benzodiazepine dose (in diazepam equivalents) administered to participants was 30 mg (IQR, 0‐65) for TAU and 5 mg (IQR, 0‐30) for the protocol group ( P < .001). Adverse events before and after implementation occurred in 4.8% and 0%, respectively ( P = .15). Conclusion and Scientific Significance This study provides preliminary evidence for the efficacy and safety of a novel standardized AWS protocol for psychiatric inpatients. This is the first known study assessing an AWS assessment and treatment protocol designed for psychiatric inpatients. (Am J Addict 2020;29:500–507)