Social factors and readmission after inpatient detoxification in older alcohol‐dependent patients

Berg, Julia F. van den; Brink, Wim van den; Kist, Nicolien; Hermes, Jolanda S.J.; Kok, Rob M.

doi:10.1111/ajad.12287

Cited by 8 publications

(4 citation statements)

References 31 publications

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“…These patients also yielded more previous admissions, comorbidities, and accidents involving poisoning, adverse drug reactions, or falls. A study from the Netherlands in this age group found that spending leisure time alone was associated with higher readmission rates (7).…”

Section: Introductionmentioning

confidence: 90%

Patient-Level Predictors of Psychiatric Readmission in Substance Use Disorders

Böckmann¹,

Lay²,

Seifritz

et al. 2019

Front. Psychiatry

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Repeated psychiatric readmissions are a particular challenge in the treatment of substance use disorders and are associated with substantial burden for patients and their associates and for healthcare providers. Factors affecting readmission rates are heterogeneous and need to be identified to better allocate resources. Within the Swiss healthcare system, such data on substance use disorder patients are largely missing. Understanding these factors might bear important implications for future healthcare planning. Thus here, we examine risk factors of inpatient readmission. We retrospectively analyzed all admissions to the hospital's department of addictive disorders in the year 2016. Patients included in the study were followed over a period of 1 year after discharge regarding readmissions to the clinic. Besides the demographic, social, and economic data, we extracted data concerning patient history, admission, and discharge as well as clinical data regarding type and number of substances abused and comorbid diagnoses. In order to describe severity of cases, we furthermore included the scores of the Health of the Nation Outcome Scale (HoNOS) at admission and at discharge as documented in the medical database. Of the 554 patients included in the study, 228 (41.2%) were readmitted within 12 months. Previous admissions, concomitant use of different substances, presence of psychosis or mania, and a higher severity score at discharge increased the likelihood of readmission. The odds for readmission were furthermore higher in patients not being married, living alone, and being unemployed. When all (bivariate) statistically significant factors are included into a logistic regression model, the previous number of admissions and the HoNOS clinical score at discharge significantly contributed to this model. Our findings stress that patients with higher symptom load at discharge are prone to be readmitted within 12 months. The same applies for patients with previous admissions. These findings suggest that the development of specific interventions to prevent premature discharge before satisfactory symptom remission, in particular in those patients with previous admissions in their patient history, might help to prevent readmissions.

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Section: Introductionmentioning

confidence: 90%

Patient-Level Predictors of Psychiatric Readmission in Substance Use Disorders

Böckmann¹,

Lay²,

Seifritz

et al. 2019

Front. Psychiatry

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“…The time‐frame for readmissions varied greatly from within 30 days of discharge [ 25 ] to within 2.5 years of discharge [ 65 ]. Other outcomes related to relapse include the use of a Maudsley Addiction Profile and author‐created questionnaire to determine factors related to relapse in one study [ 66 ] and measuring the effect of social factors on relapse in another [ 67 ].…”

Section: Resultsmentioning

confidence: 99%

A narrative review of outcome measures used in drug and alcohol inpatient withdrawal treatment research

Wang

Deane

Kelly

et al. 2023

Drug and Alcohol Review

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Issues: Assessing drug and alcohol inpatient withdrawal treatment programs is important, as these represent a first step of treatment among people with alcohol and drug problems. However, there are many ways of measuring outcomes making it difficult for service providers to decide which domains and methods to use. This narrative review aims to clarify frequencies of the domains and methods used to assess withdrawal treatment outcomes. Approach: We reviewed published studies that examined outcomes of inpatient drug and alcohol withdrawal treatment. The types of outcome measures used and the frequency of use were summarised.

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“…It is necessary because withdrawal from alcohol (and other sedative-hypnotics) that is not medically managed may lead to autonomic instability, seizures, delirium, or death. Opioid withdrawal syndrome poses nearly no mortality risk but can be protracted with intense symptoms, and the risk from overdose is significant for patients who relapse after withdrawal because of loss of opioid tolerance (VA/DoD, 2015).…”

Section: Treatment and Outcomes Among Detoxification Inpatientsmentioning

confidence: 99%

Randomized controlled trial of enhanced telephone monitoring with detoxification patients: 3- and 6-month outcomes

Timko

Below

Vittorio

et al. 2019

Journal of Substance Abuse Treatment

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Telehealth interventions have the potential to deter repeated detoxification episodes and improve outcomes. Using a sample of 298 detoxification inpatients, this randomized controlled trial compared Enhanced Telephone Monitoring (ETM) to usual care (UC) on the primary outcome of reducing subsequent detoxification, and secondary outcomes of linking patients to addiction treatment and mutual-help, and patients' experience of improved substance use and mental health outcomes. At the 3-month follow-up (i.e., at the end of the ETM intervention), compared to UC patients, ETM patients were significantly less likely to have received additional inpatient detoxification, but no more likely to have participated in 12-step groups or received outpatient addiction treatment. Even so, ETM patients had better alcohol, drug, and mental health outcomes. In contrast, at the 6-month follow-up, patients in ETM and UC generally did not differ on primary or secondary outcomes. Findings suggest that ETM deters additional detoxification episodes while the intervention is ongoing, but not after the intervention ends. Because telephone monitoring is low-intensity and low-cost, its extension over time may help reduce repeated detoxifications.

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Social factors and readmission after inpatient detoxification in older alcohol‐dependent patients

Abstract: This study shows that most social factors are-unexpectedly-not associated with rehospitalization of older alcohol-dependent patients after detoxification. "Spending leisure time alone" warrants further study as a potentially modifiable predictor.

Cited by 8 publications

References 31 publications

Patient-Level Predictors of Psychiatric Readmission in Substance Use Disorders

Patient-Level Predictors of Psychiatric Readmission in Substance Use Disorders

A narrative review of outcome measures used in drug and alcohol inpatient withdrawal treatment research

Randomized controlled trial of enhanced telephone monitoring with detoxification patients: 3- and 6-month outcomes

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