Using clinical decision support through the electronic medical record to increase prescribing of high-dose parenteral thiamine in hospitalized patients with alcohol use disorder

Abstract

BACKGROUND-Patients with alcohol use disorder (AUD) are at an increased risk of developing Wernicke's encephalopathy (WE), a devastating and difficult diagnosis caused by thiamine deficiency. Even as AUD is present in up to 25% of hospitalized patients on medical floors, appropriate thiamine supplementation in the hospital setting remains inadequate. These patients are particularly susceptible to thiamine deficiency and subsequent WE due to both their alcohol use and active medical illnesses. The electronic medical record (EMR) has become ubiquitous in health care systems and can be used as a tool to improve the care of hospitalized patients.

A Study of Factors Affecting on Patients’ Length of Stay in a Surgical Ward: Toward Optimization by Technology-based Solutions

“…-Detection of drug interventions, drug side-effects or sensitivities, and clinical deterioration [19,20] √ √ √…”

Things We Do for No Reason™: Prescribing Thiamine, Folate and Multivitamins on Discharge for Patients With Alcohol Use Disorder

“…Given the consequences of missing a deficiency, alcohol withdrawal-management order sets commonly embed vitamin repletion orders. 6…”

Automated Electrical Quantification of Vitamin B1 in a Bodily Fluid using an Engineered Nanopore Sensor

“…[1,2] Deficiencyo ft hiamine can lead to ar ange of non-specific symptoms,d elaying diagnosis of its underlying cause and thereby potentially leading to permanent neural degeneration. Thec linical relevance is not only limited to beriberi-related diseases (e.g.W ernicke encephalopathy and Korsakoff syndrome), [3][4][5][6] but research has also highlighted thiamine as ap otential biomarker for certain neurodegenerative diseases. [7][8][9] Thed etection of thiamine is commonly performed using liquid chromatography,w hich requires ar elatively high level of expertise and is time-consuming.…”

“…The clinical relevance is not only limited to beriberi‐related diseases (e.g. Wernicke encephalopathy and Korsakoff syndrome),[ 3 , 4 , 5 , 6 ] but research has also highlighted thiamine as a potential biomarker for certain neurodegenerative diseases. [ 7 , 8 , 9 ] The detection of thiamine is commonly performed using liquid chromatography, which requires a relatively high level of expertise and is time‐consuming.…”