Management of addiction medicine: sharing medicine?

Bottaro, Luigi Carlo; Leone, Silvia; Sampietro, Lorenzo; Balbinot, Patrizia; Pellicano, Rinaldo; Testino, Gianni

doi:10.23736/s0026-4806.19.06257-8

Cited by 20 publications

(6 citation statements)

References 11 publications

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“…Different from what has been mistakenly suggested ( Knight et al, 2020 , Gavelli et al, 2020 , Halalau et al, 2021 , Galloway et al, 2020 ), the results from this study do not suggest that patients from low-risk group may be discharged for home treatment. No score so far has specifically tested this hypothesis.…”

Section: Discussioncontrasting

confidence: 99%

“…Imputed missing values by chained equations (MICE) with predictive mean matching Yes. NLP was used to identify presenting symptoms Yes: COVID-19 Inpatient Risk Calculator (CIRC) 24 No 131 Sourij ( Sourij et al, 2020 ) Mortality In-hospital Multivariate logistic regression No No Yes Not clear Yes 58 Gavelli ( Gavelli et al, 2020 ) In-hospital mortality and in-hospital clinical stability In-hospital Multivariable logistic regression and Cox Regression Hazard models No No Yes (NOVARA score) NA No NA (consensus) Kazemi ( Kazemi et al, 2020 ) Mortality In-hospital Multivariate logistic regression No No Yes (authors created a CT score not based on the data) Not available No 11 Núñez-Gil ( Nunez-Gil et al, 2020 ) Mortality In-hospital Multivariate logistic regression No No Yes Not clear Yes 311 Allenbach ( Allenbach et al, 2020 ) Composite of ICU admission or death 14 days Multivariate logistic regression No No Yes 42 Yes 32 Kim ( Kim et al, 2020 ) Mortality In-hospital Consensus No No Yes 3 No 7 Altschul ( Altschul et al, 2020 ) Mortality In-hospital Multivariate logistic regression No <...>…”

Section: Resultsmentioning

confidence: 99%

“…Complete case analysis, and predictors with >20% missing values were excluded. No external validation Gavelli ( Gavelli et al, 2020 ) Presence of comorbidity (any disease on active therapy), SpO2 and respiratory rate after a trial of 15 minutes with oxygen at a FiO2 0.5 No Points-based score NA Not reported Score developed by consensus. Modest sample size.…”

Section: Resultsmentioning

confidence: 99%

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ABC2-SPH risk score for in-hospital mortality in COVID-19 patients: development, external validation and comparison with other available scores

Marcolino

Pires²,

Ramos³

et al. 2021

International Journal of Infectious Diseases

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Objectives The majority of available scores to assess mortality risk of coronavirus disease 19 (COVID-19) patients in the emergency department have high risk of bias. Therefore, our aim was to develop and validate a score at hospital admission for predicting in-hospital mortality in COVID-19 patients, and to compare this score with other existing ones. Methods Consecutive patients (≥18 years) with confirmed COVID-19 admitted to the participating hospitals were included. Logistic regression analysis was performed to develop a prediction model for in-hospital mortality, based on the 3978 patients admitted between March-July, 2020. The model was validated in the 1054 patients admitted during August-September, as well as in an external cohort of 474 Spanish patients. Results Median (25th-75th percentile) age of the model-derivation cohort was 60 (48-72) years, and in-hospital mortality was 20.3%. The validation cohorts had similar age distribution and in-hospital mortality. Seven significant variables were included in the risk score: age, blood urea nitrogen, number of comorbidities, C-reactive protein, SpO 2 /FiO 2 ratio, platelet count and heart rate. The model had high discriminatory value (AUROC 0.844, 95% CI 0.829 to 0.859), which was confirmed in the Brazilian (0.859 [95% CI 0.833 to 0.885]) and Spanish (0.894 [95% CI 0.870 to 0.919]) validation cohorts, and displayed better discrimination ability than other existing scores. It is implemented in a freely available online risk calculator (https://abc2sph.com/). Conclusions We designed and validated an easy-to-use rapid scoring system based on characteristics of COVID-19 patients commonly available at hospital presentation, for early stratification for in-hospital mortality risk of patients with COVID-19.

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Section: Discussioncontrasting

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

ABC2-SPH risk score for in-hospital mortality in COVID-19 patients: development, external validation and comparison with other available scores

Marcolino

Pires²,

Ramos³

et al. 2021

International Journal of Infectious Diseases

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“…Moreover, as happened when dealing with HIV and hepatitis C virus (HCV) infections when shared interventions between clinicians and researchers working in the fields of addiction diseases, infection diseases, and hepato‐gastroenterology combined their forces and achieved excellent results which brought HIV towards a treatable and chronic disease and HCV towards its complete resolution, multidisciplinary and shared clinical intervention needs to be actively renewed in dealing with the current health crisis. 84 , 85 Namely, the clinical approach in the management of AUD patients with alcohol‐related liver disease and ALC needs a profound rearrangement with a strict collaboration of several professional figures experts in alcohol addiction treatment (physicians and psychologists), gastroenterologists, hepatologists and surgeons to guarantee safety to professional staff and patients together with helping patients in achieving and maintain alcohol abstinence in a condition of isolation. 50 Lastly, peers and caregiver such as family member play a crucial role.…”

Section: Discussionmentioning

confidence: 99%

Alcohol use disorder in the COVID‐19 era: Position paper of the Italian Society on Alcohol (SIA)

Testino

Vignoli²,

Patussi

et al. 2021

Addiction Biology

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Coronavirus disease 2019 (COVID‐19) first emerged in China in November 2019. Most governments have responded to the COVID‐19 pandemic by imposing a lockdown. Some evidence suggests that a period of isolation might have led to a spike in alcohol misuse, and in the case of patients with alcohol use disorder (AUD), social isolation can favour lapse and relapse. The aim of our position paper is to provide specialists in the alcohol addiction field, in psychopharmacology, gastroenterology and in internal medicine, with appropriate tools to better manage patients with AUD and COVID‐19,considering some important topics: (a) the susceptibility of AUD patients to infection; (b) the pharmacological interaction between medications used to treat AUD and to treat COVID‐19; (c) the reorganization of the Centre for Alcohol Addiction Treatment for the management of AUD patients in the COVID‐19 era (group activities, telemedicine, outpatients treatment, alcohol‐related liver disease and liver transplantation, collecting samples); (d) AUD and SARS‐CoV‐2 vaccination. Telemedicine/telehealth will undoubtedly be useful/practical tools even though it remains at an elementary level; the contribution of the family and of caregivers in the management of AUD patients will play a significant role; the multidisciplinary intervention involving experts in the treatment of AUD with specialists in the treatment of COVID‐19 disease will need implementation. Thus, the COVID‐19 pandemic is rapidly leading addiction specialists towards a new governance scenario of AUD, which necessarily needs an in‐depth reconsideration, focusing attention on a safe approach in combination with the efficacy of treatment.

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“…Thus, the COVID-19 pandemic has rapidly carried us toward a new governance scenario of AUD and ALD which necessarily requires an in-depth review of the management of these diseases, with a new safe approach without losing the therapeutic efficacy of multidisciplinary treatment [ 98 , 99 ].…”

Section: Discussionmentioning

confidence: 99%

Alcohol-Related Liver Disease in the Covid-19 Era: Position Paper of the Italian Society on Alcohol (SIA)

et al. 2021

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Background Coronavirus Disease 2019 (COVID-19), firstly reported in China last November 2019, became a global pandemic. It has been shown that periods of isolation may induce a spike in alcohol use disorder (AUD). In addition, alcohol-related liver disease (ALD) is the most common consequence of excessive alcohol consumption worldwide. Moreover, liver impairment has also been reported as a common manifestation of COVID-19. Aims The aim of our position paper was to consider some critical issues regarding the management of ALD in patients with AUD in the era of COVID-19. Methods A panel of experts of the Italian Society of Alcohology (SIA) met via “conference calls” during the lockdown period to draft the SIA’s criteria for the management of ALD in patients with COVID-19 as follows: (a) liver injury in patients with ALD and COVID-19 infection; (b) toxicity to the liver of the drugs currently tested to treat COVID-19 and the pharmacological interaction between medications used to treat AUD and to treat COVID-19; (c) reorganization of the management of compensated and decompensated ALD and liver transplantation in the COVID-19 era. Results and Conclusions The COVID-19 pandemic has rapidly carried us toward a new governance scenario of AUD and ALD which necessarily requires an in-depth review of the management of these diseases with a new safe approach (management of out-patients and in-patients following new rules of safety, telemedicine, telehealth, call meetings with clinicians, nurses, patients, and caregivers) without losing the therapeutic efficacy of multidisciplinary treatment.

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Management of addiction medicine: sharing medicine?

Cited by 20 publications

References 11 publications

ABC2-SPH risk score for in-hospital mortality in COVID-19 patients: development, external validation and comparison with other available scores

ABC2-SPH risk score for in-hospital mortality in COVID-19 patients: development, external validation and comparison with other available scores

Alcohol use disorder in the COVID‐19 era: Position paper of the Italian Society on Alcohol (SIA)

Alcohol-Related Liver Disease in the Covid-19 Era: Position Paper of the Italian Society on Alcohol (SIA)

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