SHM Converge Scientific Abstract ePoster Gallery-Medications for Aud and Discharge Follow-Up After Inpatient Alcohol Detoxification

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This multicenter retrospective cohort study examined 594 Veterans hospitalized for alcohol withdrawal across 19 VHA sites to assess discharge medications for alcohol use disorder (AUD), follow-up referrals, and 30-day readmission and 6-month drinking outcomes.<br /><br />Half of patients were discharged on an AUD medication, most commonly gabapentin (29.8%) or naltrexone (26.3%); acamprosate, disulfiram, and topiramate were used infrequently. Most patients had some discharge follow-up, but only 12.5% were referred to residential treatment.<br /><br />Outcomes were poor overall: 25.5% were readmitted within 30 days, and 66.5% returned to heavy drinking by 6 months. Patients with more medical comorbidity, prior alcohol withdrawal admissions, co-occurring substance use disorders, and discharge against medical advice had worse outcomes.<br /><br />In adjusted analyses, prescribing AUD medications at discharge was not associated with lower 30-day readmission or improved 6-month abstinence. Likewise, outpatient substance use treatment programs, substance use clinic appointments, and primary care follow-up were not linked to better outcomes. The only discharge intervention associated with improved outcomes was referral to residential treatment: it was associated with lower 30-day readmission and higher 6-month abstinence.<br /><br />The authors conclude that commonly used AUD medications and standard outpatient follow-up did not improve post-discharge outcomes after hospitalization for alcohol withdrawal. They suggest that residential treatment programs may be a more effective discharge option for selected motivated patients and that health systems should consider expanding access to these programs.

Asset Subtitle

Nazima Allaudeen

Meta Tag

Author List Anand Jagannath, Cherinne Arundel, Christine Mitchell, Craig Gunderson, Jaclyn Vargas, Jessica Cyr, Joel Boggan, Joel Elzweig, Joyce Akwe, Judith Gutierrez, Kirsha Gordon, Matthew Hoegh, Matthew Ronan, Meghna Shah, Micah Pescetto, Michael Krug, Nazim

Category Research

Concept Alcohol Use Disorder

Concept Alcohol Withdrawal

Concept 30-Day Readmission

Concept 6-month Abstinence

Concept Discharge Medication

Distinguished Non-Finalist

Presenter Organization Veterans Affairs Palo Alto Health Care System

Presenting Author Nazima Allaudeen

Track Transitions of Care

Keywords

alcohol withdrawal

alcohol use disorder

Veterans Health Administration

retrospective cohort

discharge medications

gabapentin

naltrexone

30-day readmission

heavy drinking

residential treatment

Alcohol Use Disorder

Alcohol Withdrawal

30-Day Readmission

6-month Abstinence

Discharge Medication