Management of medically assisted withdrawal from alcohol in acute adult mental health and specialist addictions in-patient services: UK clinical audit findings
Management of medically assisted withdrawal from alcohol in acute adult mental health and specialist addictions in-patient services: UK clinical audit findings
BACKGROUND: Medically assisted alcohol withdrawal (MAAW) is increasingly undertaken on acute adult psychiatric wards.
AIMS: Comparison of the quality of MAAW between acute adult wards and specialist addictions units in mental health services.
METHOD: Clinical audit conducted by the Prescribing Observatory for Mental Health (POMH). Information on MAAW was collected from clinical records using a bespoke data collection tool.
RESULTS: Forty-five National Health Service (NHS) mental health trusts/healthcare organisations submitted data relating to the treatment of 908 patients undergoing MAAW on an acute adult ward or psychiatric intensive care unit (PICU) and 347 admitted to a specialist NHS addictions unit. MAAW had been overseen by an addiction specialist in 33 (4%) of the patients on an acute adult ward/PICU. A comprehensive alcohol history, measurement of breath alcohol, full screening for Wernicke's encephalopathy, use of parenteral thiamine, prescription of medications for relapse prevention (such as acamprosate) and referral for specialist continuing care of alcohol-related problems following discharge were all more commonly documented when care was provided on a specialist unit or when there was specialist addictions management on an acute ward.
CONCLUSIONS: The findings suggest that the quality of care provided for medically assisted withdrawal from alcohol, including the use of evidence-based interventions, is better when clinicians with specialist addictions training are involved. This has implications for future quality improvement in the provision of MAAW in acute adult mental health settings.
Sinclair, Julia
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Barnes, Thomas R E
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Lingford-Hughes, Anne
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Drummond, Colin
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Loubser, Ignatius
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Rendora, Olivia
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Paton, Carol
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Sinclair, Julia
be3e54d5-c6da-4950-b0ba-3cb8cdcab13c
Barnes, Thomas R E
3ae0ce78-0404-47dc-b54f-795ba8235e0e
Lingford-Hughes, Anne
0906e538-7ef1-498a-8d02-8850ff3f01e0
Drummond, Colin
87227d1b-4253-42b7-9ee4-f9ac7c7d37b3
Loubser, Ignatius
06120828-8d55-49f0-818a-9e3f9d4b3abb
Rendora, Olivia
c176c58c-7fb2-4051-a28c-7e0bb62749f5
Paton, Carol
043a1435-5b76-4992-9567-5489a93ffe4a
Sinclair, Julia, Barnes, Thomas R E, Lingford-Hughes, Anne, Drummond, Colin, Loubser, Ignatius, Rendora, Olivia and Paton, Carol
(2023)
Management of medically assisted withdrawal from alcohol in acute adult mental health and specialist addictions in-patient services: UK clinical audit findings.
BJPsych Open, 9 (3), [e61].
(doi:10.1192/bjo.2023.45).
Abstract
BACKGROUND: Medically assisted alcohol withdrawal (MAAW) is increasingly undertaken on acute adult psychiatric wards.
AIMS: Comparison of the quality of MAAW between acute adult wards and specialist addictions units in mental health services.
METHOD: Clinical audit conducted by the Prescribing Observatory for Mental Health (POMH). Information on MAAW was collected from clinical records using a bespoke data collection tool.
RESULTS: Forty-five National Health Service (NHS) mental health trusts/healthcare organisations submitted data relating to the treatment of 908 patients undergoing MAAW on an acute adult ward or psychiatric intensive care unit (PICU) and 347 admitted to a specialist NHS addictions unit. MAAW had been overseen by an addiction specialist in 33 (4%) of the patients on an acute adult ward/PICU. A comprehensive alcohol history, measurement of breath alcohol, full screening for Wernicke's encephalopathy, use of parenteral thiamine, prescription of medications for relapse prevention (such as acamprosate) and referral for specialist continuing care of alcohol-related problems following discharge were all more commonly documented when care was provided on a specialist unit or when there was specialist addictions management on an acute ward.
CONCLUSIONS: The findings suggest that the quality of care provided for medically assisted withdrawal from alcohol, including the use of evidence-based interventions, is better when clinicians with specialist addictions training are involved. This has implications for future quality improvement in the provision of MAAW in acute adult mental health settings.
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Alcohol detox paper BJPsych Open Revised version 3 February 2023 copy
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management-of-medically-assisted-withdrawal-from-alcohol-in-acute-adult-mental-health-and-specialist-addictions-in-patient-services-uk-clinical-audit-findings
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e-pub ahead of print date: 11 April 2023
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Local EPrints ID: 476777
URI: http://eprints.soton.ac.uk/id/eprint/476777
ISSN: 2056-4724
PURE UUID: beb2e5e4-63f3-4036-890f-e4276275ddb0
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Date deposited: 15 May 2023 17:06
Last modified: 16 May 2023 01:33
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Author:
Thomas R E Barnes
Author:
Anne Lingford-Hughes
Author:
Colin Drummond
Author:
Ignatius Loubser
Author:
Olivia Rendora
Author:
Carol Paton
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