Symptom-Triggered Alcohol Withdrawal Management Delivered Over Telemedicine.

Abstract

Alcohol use is one of the leading causes of death and disability globally; however, access to evidence-based care for alcohol use disorder (AUD) is limited. Although telemedicine-based interventions promise to expand treatment access, there are no validated telemedicine-based interventions for alcohol withdrawal management. In this single-arm study, we sought to determine the feasibility of delivering symptom-triggered alcohol withdrawal management over telemedicine. Thirty actively drinking participants with AUD and a history of alcohol withdrawal were recruited to participate. Participants were scheduled for 3 days of symptom-triggered withdrawal management using the Clinical Institute Withdrawal Assessment for Alcohol Scale Revised delivered by a trained clinician over a telemedicine platform. Primary outcomes were retention in treatment and need for transfer to a higher level of care (eg, the emergency room). Satisfaction with the treatment protocol and relapse to any alcohol use 30 days following treatment initiation were also assessed. In total, 93.3% of participants completed all 3 days of alcohol withdrawal management. No participants required transfer to a higher level of care. Satisfaction with treatment was high, with an average Client Satisfaction Questionnaire-8 score of 30.9 (SD = 1.5) out of 32. After the follow-up period, 56.7% of participants remained abstinent from alcohol. Our study provides preliminary evidence that symptom-triggered alcohol withdrawal management over telemedicine is feasible and satisfactory for patients. If these findings are replicated, they could have important implications for access to alcohol withdrawal management services, especially in remote, rural, and underserved regions that lack specialized withdrawal management facilities.