Assessment of Pharmacological Treatment Quality: Comparison of Symptom-triggered vs. Fixed-schedule Alcohol Withdrawal in Clinical Practice.
Introduction:Despite the fact, that symptom-triggered alcohol withdrawal treatment is recommended by German guidelines on alcoholism, many hospitals continue to use fixed-schedule protocols, as they have been successfully applied for many years.Methods:This retrospective study compared all patients' records of alcohol withdrawal treatment from October 2010 to November 2011 at Magdeburg's University Department of Psychiatry (n=120). A symptom-triggered protocol with clomethiazole (AESB, n=46) was used in parallel with the existing fixed-schedule protocol with diazepam (n=74).Results:The symptom-triggered group showed less need of pharmacological treatment duration (p<0.001) and cumulative dosage of medication compared to the fixed-schedule protocol (p<0.006). No difference was observed regarding the need of clonidine or haloperidol (to treat blood pressure derailment or delirium) and the incidence of epileptic seizures.Discussion:Based on the shorter treatment duration and a similar rate of complications our department has switched to the symptom-triggered protocol to improve the quality of patient care.
Department of Psychiatry and Psychotherapy, Otto-von-Guericke-University, Magdeburg, Germany.
U J
UJ
Müller
Department of Psychiatry and Psychotherapy, Otto-von-Guericke-University, Magdeburg, Germany.
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Schuermann
Department of Psychiatry and Psychotherapy, Otto-von-Guericke-University, Magdeburg, Germany.
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Dobrowolny
Department of Psychiatry and Psychotherapy, Otto-von-Guericke-University, Magdeburg, Germany.
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T
Frodl
Department of Psychiatry and Psychotherapy, Otto-von-Guericke-University, Magdeburg, Germany.
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B
Bogerts
Department of Psychiatry and Psychotherapy at Langenhangen, Hospitals of Hannover Region, Hannover, Germany.
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S
Mohr
Department of Psychiatry and Psychotherapy, Otto-von-Guericke-University, Magdeburg, Germany.
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J
Steiner
D000328:Adult; D020751:Alcohol-Induced Disorders / Q000188:drug therapy* / Q000517:prevention & control*; D002719:Chlormethiazole / Q000627:therapeutic use*; D003975:Diazepam / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D018757:GABA Modulators / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies
D018757:GABA Modulators; D002719:Chlormethiazole; D003975:Diazepam