Outcomes After Implementation of an Alcohol Withdrawal Protocol at a Single Institution
| Autor: | Kelly W. Davis, Anna Lockwood, Sean M Lockwood, Mary E. Eberly |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Pharmacology
Delirium tremens Benzodiazepine medicine.drug_class business.industry Cumulative dose Alcohol Pharmacy Original Articles medicine.disease 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine chemistry Anesthesia medicine Pharmacology (medical) 030212 general & internal medicine Dosing Single institution Adverse effect business Diazepam 030217 neurology & neurosurgery medicine.drug |
| Popis: | Background There are varying dosing strategies for the administration of benzodiazepines in the setting of alcohol withdrawal. In October 2014, a symptom-based alcohol withdrawal protocol (AWP) using the Clinical Institute Withdrawal Assessment of Alcohol, Revised (CIWA-Ar) scale was implemented at one institution. Objective To evaluate the safety and efficacy of the AWP. Methods Retrospective chart review was completed, including patients receiving at least one dose of diazepam for alcohol withdrawal pre- and post-protocol. The primary outcome of this study was the average daily and cumulative dose of diazepam during hospital stay. Secondary outcomes included length of stay and occurrence of seizures or delirium tremens. Results The average daily dose and the average cumulative dose of diazepam were significantly lower in the post-protocol group (5.4 vs 12.1 mg, p < .001; 35.0 vs 77.6 mg, p < .001, respectively). Length of stay was similar between groups (6.5 vs 6.4 days, p = .91), however, duration of benzodiazepine use was decreased in the post-protocol group (2.2 vs 4.7 days, p < .001). Despite using reduced doses of benzodiazepines, there was no increase in adverse events. Conclusions The implementation of a symptom-based AWP using the CIWA-Ar scale was associated with a reduced average daily and cumulative dose of diazepam without any apparent safety issues. |
| Databáze: | OpenAIRE |
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