Who needs inpatient detox? Development and implementation of a hospitalist protocol for the evaluation of patients for alcohol detoxification.
J Gen Intern Med
; 29(4): 587-93, 2014 Apr.
Article
em En
| MEDLINE
| ID: mdl-24395104
ABSTRACT
BACKGROUND:
Clinicians caring for patients seeking alcohol detoxification face many challenges, including lack of evidence-based guidelines for treatment and high recidivism rates.OBJECTIVES:
To develop a standardized protocol for determining which alcohol dependent patients seeking detoxification need inpatient versus outpatient treatment, and to study the protocol's implementation.DESIGN:
Review of best evidence by ad hoc task force and subsequent creation of standardized protocol. Prospective observational evaluation of initial protocol implementation.PARTICIPANTS:
Patients presenting for alcohol detoxification. INTERVENTION Development and implementation of a protocol for evaluation and treatment of patients requesting alcohol detoxification. MAINMEASURES:
Number of admissions per month with primary alcohol related diagnosis (DRG), 30-day readmission rate, and length of stay, all measured before and after protocol implementation.RESULTS:
We identified one randomized clinical trial and three cohort studies to inform the choice of inpatient versus outpatient detoxification, along with one prior protocol in this population, and combined that data with clinical experience to create an institutional protocol. After implementation, the average number of alcohol related admissions was 15.9 per month, compared with 18.9 per month before implementation (p = 0.037). There was no difference in readmission rate or length of stay.CONCLUSIONS:
Creation and utilization of a protocol led to standardization of care for patients requesting detoxification from alcohol. Initial evaluation of protocol implementation showed a decrease in number of admissions.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Desenvolvimento de Programas
/
Médicos Hospitalares
/
Alcoolismo
/
Necessidades e Demandas de Serviços de Saúde
/
Hospitalização
Tipo de estudo:
Clinical_trials
/
Evaluation_studies
/
Guideline
/
Observational_studies
/
Prognostic_studies
Limite:
Humans
Idioma:
En
Revista:
J Gen Intern Med
Assunto da revista:
MEDICINA INTERNA
Ano de publicação:
2014
Tipo de documento:
Article