Category: Federal Forum Posters
Purpose: Detoxification is the management of acute intoxication and withdrawal, and includes fostering patient readiness for entry into treatment for alcohol use disorder. Compared to inpatient, evidence suggests that ambulatory detoxification of mild-to-moderate alcohol withdrawal is equally effective, safe, and less expensive. The Veterans Affairs Salt Lake City Health Care System does not currently have a protocol for ambulatory alcohol detoxification. The main objective of this evaluation is to determine the prevalence of inpatient admissions for alcohol withdrawal who meet criteria for ambulatory detoxification.
Methods: A retrospective review of admissions with primary diagnosis of alcohol withdrawal (AW) was conducted from June 2016 to June 2017. Initial chart review provided demographics, blood alcohol concentration (BAC), Clinical Institute Withdrawal Assessment-Revised (CIWA-Ar) scores, and history of withdrawal seizures and delirium tremens (DTs). Admissions with an initial CIWA-Ar > 15 and a BAC > 200 mg/dL will be excluded. Further chart review for remaining exclusion criteria will be performed. Additional collected data will include the presence of: seizure disorder requiring chronic anticonvulsant therapy, medications interfering with detoxification, urinary drug screen, active seizures or DTs, offer for addiction treatment services (ATS) referral and medication assisted therapy (MAT), an ATS consult, and new MAT at discharge. The primary outcome is the percentage of admissions for AW that meet objective criteria for ambulatory detoxification. The secondary outcomes include: percentage of admissions with an offer for ATS referral, an ATS consult at discharge, an offer for MAT, and MAT on discharge. In a secondary analysis, admissions without a history of withdrawal seizures and those with a BAC >200 mg/dL will be evaluated to determine the percentage that meet criteria for ambulatory detoxification. Descriptive statistics will be used for evaluation and interpretation.
Results: not applicable
Conclusion: not applicable
Chelsea Capley– PGY1 Pharmacy Resident, Veterans Affairs Salt Lake City Health Care System, Salt Lake City, UT