Research Needs for Inpatient Management of Severe Alcohol Withdrawal Syndrome: An Official American Thoracic Society Research Statement
| Autor: | Hayley B. Gershengorn, Anuj B. Mehta, Ellen L. Burnham, Christine Timko, Darius A. Rastegar, Mayur B. Patel, Dwayne W. Godwin, Lewis S. Nelson, Nicholas W. Gilpin, Brendan J Clark, Judith A. Tate, Sarah E. Jolley, Catherine L. Hough, Joanna L. Stollings, Scott Edwards, Tessa L. Steel, Majid Afshar, Adrian Wong, Boris Tabakoff, Amy L. Dzierba, Ivor S. Douglas, José R. Maldonado |
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| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Quality management Biomedical Research Critical Care Critical Care and Intensive Care Medicine Translational Research Biomedical medicine Humans clinical studies alcohol withdrawal delirium Societies Medical American Thoracic Society Documents Ethanol business.industry Central Nervous System Depressants Research statement Research needs medicine.disease Alcohol Withdrawal Delirium Quality Improvement Call to action Substance Withdrawal Syndrome Hospitalization Alcoholism Family medicine Alcohol withdrawal syndrome translational medical research Implementation research Translational science business Needs Assessment |
| Zdroj: | American Journal of Respiratory and Critical Care Medicine |
| ISSN: | 1535-4970 |
| Popis: | Background: Severe alcohol withdrawal syndrome (SAWS) is highly morbid, costly, and common among hospitalized patients, yet minimal evidence exists to guide inpatient management. Research needs in this field are broad, spanning the translational science spectrum. Goals: This research statement aims to describe what is known about SAWS, identify knowledge gaps, and offer recommendations for research in each domain of the Institute of Medicine T0-T4 continuum to advance the care of hospitalized patients who experience SAWS. Methods: Clinicians and researchers with unique and complementary expertise in basic, clinical, and implementation research related to unhealthy alcohol consumption and alcohol withdrawal were invited to participate in a workshop at the American Thoracic Society 2019 International Conference. The committee was subdivided into four groups on the basis of interest and expertise: T0-T1 (basic science research with translation to humans), T2 (research translating to patients), T3 (research translating to clinical practice), and T4 (research translating to communities). A medical librarian conducted a pragmatic literature search to facilitate this work, and committee members reviewed and supplemented the resulting evidence, identifying key knowledge gaps. Results: The committee identified several investigative opportunities to advance the care of patients with SAWS in each domain of the translational science spectrum. Major themes included 1) the need to investigate non-γ-aminobutyric acid pathways for alcohol withdrawal syndrome treatment; 2) harnessing retrospective and electronic health record data to identify risk factors and create objective severity scoring systems, particularly for acutely ill patients with SAWS; 3) the need for more robust comparative-effectiveness data to identify optimal SAWS treatment strategies; and 4) recommendations to accelerate implementation of effective treatments into practice. Conclusions: The dearth of evidence supporting management decisions for hospitalized patients with SAWS, many of whom require critical care, represents both a call to action and an opportunity for the American Thoracic Society and larger scientific communities to improve care for a vulnerable patient population. This report highlights basic, clinical, and implementation research that diverse experts agree will have the greatest impact on improving care for hospitalized patients with SAWS. |
| Databáze: | OpenAIRE |
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