Successful implementation of an alcohol-withdrawal pathway in a general hospital

Psychosomatics. Jul-Aug 2008;49(4):292-9. doi: 10.1176/appi.psy.49.4.292.

Abstract

Background: Although alcohol use and abuse are common among general-hospital inpatients, many patients are inadequately assessed and treated for alcohol withdrawal.

Objective: The purpose of this study was to determine whether the implementation of a clinical pathway for the treatment of alcohol withdrawal in medical inpatients would result in improvements in clinical practice and patient outcomes.

Method: Authors retrospectively reviewed 80 patient records (including 40 of those treated before the implementation of a pathway and 40 of those treated after pathway implementation).

Results: Assessment procedures and ordering patterns of physicians (medical house staff and staff physicians) shifted in a fashion consistent with the new treatment guidelines. Patient outcomes (e.g., length of stay and the incidence of delirium) improved for those patients who received benzodiazepines within the range of the pathway guidelines.

Conclusions: Timely assessment and staff education can shift prescription patterns, increase patient monitoring, and reduce costs associated with alcohol withdrawal.

MeSH terms

  • Alcoholism / rehabilitation*
  • Anti-Anxiety Agents / therapeutic use
  • Benzodiazepines / therapeutic use
  • Ethanol / adverse effects*
  • Female
  • Health Status
  • Hospitalization
  • Hospitals, General*
  • Humans
  • Male
  • Mass Screening
  • Middle Aged
  • Retrospective Studies
  • Substance Withdrawal Syndrome / drug therapy
  • Substance Withdrawal Syndrome / etiology*
  • Substance Withdrawal Syndrome / rehabilitation*

Substances

  • Anti-Anxiety Agents
  • Benzodiazepines
  • Ethanol