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Oral ethanol prescribing for alcohol withdrawal syndrome: initial findings and future directions following implementation within a United Kingdom National Health Service setting.
Quelch, Darren; Copland, Arlene; Kaur, Jatinder; Sarma, Nikhil; Appleyard, Carol; Nevill, Alan; Davies, Nyle; Knight, Thomas; Williams, Grace; Roderique-Davies, Gareth; John, Bev; Bradberry, Sally.
Afiliación
  • Quelch D; Sandwell and West Birmingham Hospital NHS Trust, City Hospital, Birmingham.
  • Copland A; Addictions Research Group, Applied Psychology Research and Innovation Group, Faculty of Life Sciences and Education, University of South Wales, Pontypridd.
  • Kaur J; Sandwell and West Birmingham Hospital NHS Trust, City Hospital, Birmingham.
  • Sarma N; Sandwell and West Birmingham Hospital NHS Trust, City Hospital, Birmingham.
  • Appleyard C; Sandwell and West Birmingham Hospital NHS Trust, City Hospital, Birmingham.
  • Nevill A; Sandwell and West Birmingham Hospital NHS Trust, City Hospital, Birmingham.
  • Davies N; Faculty of Education Health and Wellbeing, Wolverhampton University, Wolverhampton.
  • Knight T; Addictions Research Group, Applied Psychology Research and Innovation Group, Faculty of Life Sciences and Education, University of South Wales, Pontypridd.
  • Williams G; Sandwell and West Birmingham Hospital NHS Trust, City Hospital, Birmingham.
  • Roderique-Davies G; Sandwell and West Birmingham Hospital NHS Trust, City Hospital, Birmingham.
  • John B; Addictions Research Group, Applied Psychology Research and Innovation Group, Faculty of Life Sciences and Education, University of South Wales, Pontypridd.
  • Bradberry S; Faculty of Education Health and Wellbeing, Wolverhampton University, Wolverhampton.
Clin Toxicol (Phila) ; 62(7): 432-440, 2024 Jul.
Article en En | MEDLINE | ID: mdl-38913748
ABSTRACT

INTRODUCTION:

Prescribing of ethanol may be an alternative to benzodiazepines for managing alcohol withdrawal syndrome. We present our experience of oral ethanol prescribing within an acute United Kingdom National Health Service setting.

METHODS:

A retrospective review of patients presenting with alcohol withdrawal who were managed with oral ethanol or benzodiazepines was performed from data collected across two acute care settings. Ethanol prescribing inclusion high risk of delirium tremens, or a history of harmful alcohol consumption (typically ≥30 units/day; in which 1 unit = 8 grams of alcohol; one standard United States drink = 14 grams of alcohol) or known to have a history of severe alcohol withdrawal, alcohol-related seizures or delirium tremens. Inverse propensity score weighting was used to partially account for variance between the two patient populations.

RESULTS:

Fifty (82 per cent male; average age 50.9 years) and 93 (84 per cent male; average age 46.5 years) patients in receipt of benzodiazepines or ethanol, respectively, were included. The likelihood of hospital admission was significantly reduced when individuals were managed with ethanol (odds ratio 0.206 (95 per cent confidence interval; 0.066-0.641), Wald chi-square P = 0.006). In those not admitted, the treatment type had no significant impact on length of stay or the number of occasions a pharmacological agent was required. In those admitted, treatment had no significant effect on length of stay.

DISCUSSION:

We offer preliminary evidence to support a role of oral ethanol in the management of patients with alcohol withdrawal. We have implemented a robust and translatable guideline. Despite limitations in the data set the impact of ethanol in reducing the likelihood of admission remained significant.

CONCLUSIONS:

In individuals at significant risk of severe alcohol withdrawal, prescribing ethanol as part of a comprehensive care plan, may reduce unplanned admissions. The preliminary findings presented here warrant further assessment through prospective studies.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome de Abstinencia a Sustancias / Etanol Límite: Adult / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Clin Toxicol (Phila) Asunto de la revista: TOXICOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome de Abstinencia a Sustancias / Etanol Límite: Adult / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Clin Toxicol (Phila) Asunto de la revista: TOXICOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido