Unplanned alcohol withdrawal: a survey of consecutive admissions to an acute medical unit in 2010 and 2011

Husain, Omair; Lynas, P; Totty, Joshua; Williams, Kristina; Waring, W. Stephen

doi:10.1093/qjmed/hcs175

Cited by 3 publications

(1 citation statement)

References 12 publications

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“…The impact of addictions specialists has not been systematically studied in acute hospital settings, where published audit data are limited to the positive impact of local alcohol treatment guidelines on the quality of MAAW, particularly the use of parenteral thiamine. [16][17][18] One study conducted in a psychiatric hospital almost 20 years ago tested the impact of the introduction of a local protocol/ prescription chart on the use of parenteral thiamine during MAAW; although this intervention did increase the use of parenteral thiamine, the involvement of a specialist in a patient's care had the strongest association with the use of parenteral thiamine. 19 Do patients who receive MAAW on acute psychiatric wards and specialist alcohol units differ?…”

Section: Discussionmentioning

confidence: 99%

Management of medically assisted withdrawal from alcohol in acute adult mental health and specialist addictions in-patient services: UK clinical audit findings

et al. 2023

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Background Medically assisted alcohol withdrawal (MAAW) is increasingly undertaken on acute adult psychiatric wards. Aims Comparison of the quality of MAAW between acute adult wards and specialist addictions units in mental health services. Method Clinical audit conducted by the Prescribing Observatory for Mental Health (POMH). Information on MAAW was collected from clinical records using a bespoke data collection tool. Results Forty-five National Health Service (NHS) mental health trusts/healthcare organisations submitted data relating to the treatment of 908 patients undergoing MAAW on an acute adult ward or psychiatric intensive care unit (PICU) and 347 admitted to a specialist NHS addictions unit. MAAW had been overseen by an addiction specialist in 33 (4%) of the patients on an acute adult ward/PICU. A comprehensive alcohol history, measurement of breath alcohol, full screening for Wernicke's encephalopathy, use of parenteral thiamine, prescription of medications for relapse prevention (such as acamprosate) and referral for specialist continuing care of alcohol-related problems following discharge were all more commonly documented when care was provided on a specialist unit or when there was specialist addictions management on an acute ward. Conclusions The findings suggest that the quality of care provided for medically assisted withdrawal from alcohol, including the use of evidence-based interventions, is better when clinicians with specialist addictions training are involved. This has implications for future quality improvement in the provision of MAAW in acute adult mental health settings.

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Section: Discussionmentioning

confidence: 99%

Management of medically assisted withdrawal from alcohol in acute adult mental health and specialist addictions in-patient services: UK clinical audit findings

et al. 2023

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Trauma center admission risk conditions and the probability for developing alcohol withdrawal syndrome: A retrospective study

Marchand

Dunham²,

Chance³

et al. 2023

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Risk factors of hospitalization for any medical condition among patients with prior emergency department visits for mental health conditions

et al. 2020

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Background This longitudinal study identified risk factors for frequency of hospitalization among patients with any medical condition who had previously visited one of six Quebec (Canada) emergency departments (ED) at least once for mental health (MH) conditions as the primary diagnosis. Methods Records of n = 11,367 patients were investigated using administrative databanks (2012–13/2014–15). Hospitalization rates in the 12 months after a first ED visit in 2014–15 were categorized as no hospitalizations (0 times), moderate hospitalizations (1–2 times), and frequent hospitalizations (3+ times). Based on the Andersen Behavioral Model, data on risk factors were gathered for the 2 years prior to the first visit in 2014–15, and were identified as predisposing, enabling or needs factors. They were tested using a hierarchical multinomial logistic regression according to the three groups of hospitalization rate. Results Enabling factors accounted for the largest percentage of total variance explained in the study model, followed by needs and predisposing factors. Co-occurring mental disorders (MD)/substance-related disorders (SRD), alcohol-related disorders, depressive disorders, frequency of consultations with outpatient psychiatrists, prior ED visits for any medical condition and number of physicians consulted in specialized care, were risk factors for both moderate and frequent hospitalizations. Schizophrenia spectrum and other psychotic disorders, bipolar disorders, and age (except 12–17 years) were risk factors for moderate hospitalizations, while higher numbers (4+) of overall interventions in local community health service centers were a risk factor for frequent hospitalizations only. Patients with personality disorders, drug-related disorders, suicidal behaviors, and those who visited a psychiatric ED integrated with a general ED in a separate site, or who visited a general ED without psychiatric services were also less likely to be hospitalized. Less urgent and non-urgent illness acuity prevented moderate hospitalizations only. Conclusions Patients with severe and complex health conditions, and higher numbers of both prior outpatient psychiatrist consultations and ED visits for medical conditions had more moderate and frequent hospitalizations as compared with non-hospitalized patients. Patients at risk for frequent hospitalizations were more vulnerable overall and had important biopsychosocial problems. Improved primary care and integrated outpatient services may prevent post-ED hospitalization.

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Unplanned alcohol withdrawal: a survey of consecutive admissions to an acute medical unit in 2010 and 2011

Cited by 3 publications

References 12 publications

Management of medically assisted withdrawal from alcohol in acute adult mental health and specialist addictions in-patient services: UK clinical audit findings

Management of medically assisted withdrawal from alcohol in acute adult mental health and specialist addictions in-patient services: UK clinical audit findings

Trauma center admission risk conditions and the probability for developing alcohol withdrawal syndrome: A retrospective study

Risk factors of hospitalization for any medical condition among patients with prior emergency department visits for mental health conditions

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