Symptom-triggered detoxification using the Alcohol-Withdrawal-Scale reduces risks and health care costs

Soravia, Leila M.; Wopfner, Alexander; Pfiffner, Luzius; Bétrisey, Sophie; Moggi, Franz (2017). Symptom-triggered detoxification using the Alcohol-Withdrawal-Scale reduces risks and health care costs. Alcohol and alcoholism, 53(1), pp. 71-77. Oxford University Press 10.1093/alcalc/agx080

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Aims: As there are only a few existing experimental studies on symptom-triggered therapy for patients with alcohol withdrawal, we investigated the effectiveness of symptom-triggered detoxification regarding the use and dosage of benzodiazepine and withdrawal complications in a naturalistic clinical setting of a specialized treatment center for alcohol use disorder. Methods: In total 301 charts of patients who entered residential treatment for alcohol withdrawal were included in the retrospective analysis. Charts of 176 patients treated with the Alcohol Withdrawal- Scale (AWS) were compared to the charts of 125 patients treated with treatment as usual (TAU) before the implementation of AWS. Sociodemographical and clinical variables, previous detoxifications and complications, duration of treatment, use and dose of benzodiazepine and other withdrawal medication, complications and premature discontinuation of treatment were abstracted from the patients’ medical records. Results: The two groups did not differ in any demographical or clinical variables measured upon treatment admission. The total percentage of patients being treated with benzodiazepines during detoxification decreased from 78.4% to 38.6% after the implementation of the AWS. The implementation of the AWS significantly reduced the duration of the acute detoxification from 136 hours to 66 hours, and the use, duration and dose of benzodiazepine by nearly two-thirds while complications and treatment discontinuation remained unvaryingly. Health care costs for detoxification were reduced by half per patient. Conclusions: The findings indicate that symptom-triggered treatment for alcohol withdrawal is safe and effective in a naturalistic clinical setting and significantly reduces healthcare costs and the risk for overmedicating patients.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy > Translational Research Center
04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy

UniBE Contributor:

Soravia, Leila; Wopfner, Alexander and Moggi, Franz

Subjects:

300 Social sciences, sociology & anthropology > 360 Social problems & social services
500 Science > 570 Life sciences; biology

ISSN:

0735-0414

Publisher:

Oxford University Press

Language:

English

Submitter:

Leila Soravia

Date Deposited:

06 Dec 2017 10:37

Last Modified:

29 Oct 2019 19:50

Publisher DOI:

10.1093/alcalc/agx080

BORIS DOI:

10.7892/boris.106866

URI:

https://boris.unibe.ch/id/eprint/106866

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