• Nazima Allaudeen, Joyce Akwe, Cherinne Arundel, Joel C Boggan, Peter Caldwell, Paul B Cornia, Jessica Cyr, Erik Ehlers, Joel Elzweig, Patrick Godwin, Kirsha S Gordon, Michelle Guidry, Jeydith Gutierrez, Daniel Heppe, Matthew Hoegh, Anand Jagannath, Peter Kaboli, Michael Krug, James D Laudate, Christine Mitchell, Micah Pescetto, Benjamin A Rodwin, Matthew Ronan, Richard Rose, Meghna N Shah, Andrea Smeraglio, Meredith Trubitt, Matthew Tuck, Jaclyn Vargas, Peter Yarbrough, and Craig G Gunderson.
• Medical Service, VA Palo Alto Healthcare System, Palo Alto, California, USA.
• J Hosp Med. 2024 Jul 19.

BackgroundAlcohol withdrawal is a common reason for admission to acute care hospitals. Prescription of medications for alcohol-use disorder (AUD) and close outpatient follow-up are commonly recommended, but few studies report their effects on postdischarge outcomes.ObjectivesThe objective of this study is to evaluate the effects of medications for AUD and follow-up appointments on readmission and abstinence.MethodsThis retrospective cohort study evaluated veterans admitted for alcohol withdrawal to medical services at 19 Veteran Health Administration hospitals between October 1, 2018 and September 30, 2019. Factors associated with all-cause 30-day readmission and 6-month abstinence were examined using logistic regression.ResultsOf the 594 patients included in this study, 296 (50.7%) were prescribed medications for AUD at discharge and 459 (78.5%) were discharged with follow-up appointments, including 251 (42.8%) with a substance-use clinic appointment, 191 (32.9%) with a substance-use program appointment, and 73 (12.5%) discharged to a residential program. All-cause 30-day readmission occurred for 150 patients (25.5%) and 103 (17.8%) remained abstinent at 6 months. Medications for AUD and outpatient discharge appointments were not associated with readmission or abstinence. Discharge to residential treatment program was associated with reduced 30-day readmission (adjusted odds ratio [AOR]: 0.39, 95% confidence interval [95% CI]: 0.18-0.82) and improved abstinence (AOR: 2.50, 95% CI: 1.33-4.73).ConclusionsReadmission and return to heavy drinking are common for patients discharged for alcohol withdrawal. Medications for AUD were not associated with improved outcomes. The only intervention at the time of discharge that improved outcomes was discharge to residential treatment program, which was associated with decreased readmission and improved abstinence.Published 2024. This article is a US Government work and is in the public domain in the USA.

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