Follow-up and reasons for extended-release naltrexone discontinuation for alcohol use disorder after hospital initiation
Only 1.9% of the individuals in the USA with alcohol use disorder (AUD) receive medication for AUD. Hospitalisation presents an opportunity to identify patients with AUD and offer treatment. Extended-release naltrexone (XR-NTX) is a Food and Drug Administration-approved medication for AUD that reduc...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2024-12-01
|
| Series: | BMJ Open Quality |
| Online Access: | https://bmjopenquality.bmj.com/content/13/4/e003113.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850063411515228160 |
|---|---|
| author | Marlene Martin Manuel Seraydarian James Gasper Triveni DeFries |
| author_facet | Marlene Martin Manuel Seraydarian James Gasper Triveni DeFries |
| author_sort | Marlene Martin |
| collection | DOAJ |
| description | Only 1.9% of the individuals in the USA with alcohol use disorder (AUD) receive medication for AUD. Hospitalisation presents an opportunity to identify patients with AUD and offer treatment. Extended-release naltrexone (XR-NTX) is a Food and Drug Administration-approved medication for AUD that reduces drinking days and heavy drinking days. XR-NTX can reduce healthcare costs, decrease acute care utilisation and increase retention in treatment. We offered and initiated XR-NTX during hospitalisation to patients with moderate-to-severe AUD. We describe the follow-up rates for XR-NTX after hospital initiation and the reasons for XR-NTX discontinuation in the outpatient setting after hospital initiation. We performed a retrospective chart review of 62 hospitalised patients with moderate-to-severe AUD who received XR-NTX between 1 November 2019 and 31 December 2020. Twenty-two patients (35.5%) received ≥1 dose of XR-NTX within the first 3 months of discharge, 22 (35.5%) stopped XR-NTX and 18 (29.0%) did not follow-up. Overall, 44 (71.0%) patients followed up after discharge. Among those that discontinued XR-NTX, the most common reasons were: (1) a preference for oral NTX; (2) clinicians switching patients to oral NTX after patients missed an XR-NTX dose; (3) clinician challenges in prescribing XR-NTX; and (4) patient obstacles to accessing outpatient care. Our study highlights several opportunities to address modifiable reasons to improve access to and retention in XR-NTX treatment. |
| format | Article |
| id | doaj-art-2707e6cbaa1b4d7db9f108270f30f5ee |
| institution | DOAJ |
| issn | 2399-6641 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Quality |
| spelling | doaj-art-2707e6cbaa1b4d7db9f108270f30f5ee2025-08-20T02:49:36ZengBMJ Publishing GroupBMJ Open Quality2399-66412024-12-0113410.1136/bmjoq-2024-003113Follow-up and reasons for extended-release naltrexone discontinuation for alcohol use disorder after hospital initiationMarlene Martin0Manuel Seraydarian1James Gasper2Triveni DeFries3Department of Medicine, San Francisco General Hospital, San Francisco, California, USADepartment of Clinical Pharmacy, San Francisco General Hospital, San Francisco, California, USASan Francisco General Hospital and Trauma Center, San Francisco, California, USADepartment of Medicine, San Francisco General Hospital, San Francisco, California, USAOnly 1.9% of the individuals in the USA with alcohol use disorder (AUD) receive medication for AUD. Hospitalisation presents an opportunity to identify patients with AUD and offer treatment. Extended-release naltrexone (XR-NTX) is a Food and Drug Administration-approved medication for AUD that reduces drinking days and heavy drinking days. XR-NTX can reduce healthcare costs, decrease acute care utilisation and increase retention in treatment. We offered and initiated XR-NTX during hospitalisation to patients with moderate-to-severe AUD. We describe the follow-up rates for XR-NTX after hospital initiation and the reasons for XR-NTX discontinuation in the outpatient setting after hospital initiation. We performed a retrospective chart review of 62 hospitalised patients with moderate-to-severe AUD who received XR-NTX between 1 November 2019 and 31 December 2020. Twenty-two patients (35.5%) received ≥1 dose of XR-NTX within the first 3 months of discharge, 22 (35.5%) stopped XR-NTX and 18 (29.0%) did not follow-up. Overall, 44 (71.0%) patients followed up after discharge. Among those that discontinued XR-NTX, the most common reasons were: (1) a preference for oral NTX; (2) clinicians switching patients to oral NTX after patients missed an XR-NTX dose; (3) clinician challenges in prescribing XR-NTX; and (4) patient obstacles to accessing outpatient care. Our study highlights several opportunities to address modifiable reasons to improve access to and retention in XR-NTX treatment.https://bmjopenquality.bmj.com/content/13/4/e003113.full |
| spellingShingle | Marlene Martin Manuel Seraydarian James Gasper Triveni DeFries Follow-up and reasons for extended-release naltrexone discontinuation for alcohol use disorder after hospital initiation BMJ Open Quality |
| title | Follow-up and reasons for extended-release naltrexone discontinuation for alcohol use disorder after hospital initiation |
| title_full | Follow-up and reasons for extended-release naltrexone discontinuation for alcohol use disorder after hospital initiation |
| title_fullStr | Follow-up and reasons for extended-release naltrexone discontinuation for alcohol use disorder after hospital initiation |
| title_full_unstemmed | Follow-up and reasons for extended-release naltrexone discontinuation for alcohol use disorder after hospital initiation |
| title_short | Follow-up and reasons for extended-release naltrexone discontinuation for alcohol use disorder after hospital initiation |
| title_sort | follow up and reasons for extended release naltrexone discontinuation for alcohol use disorder after hospital initiation |
| url | https://bmjopenquality.bmj.com/content/13/4/e003113.full |
| work_keys_str_mv | AT marlenemartin followupandreasonsforextendedreleasenaltrexonediscontinuationforalcoholusedisorderafterhospitalinitiation AT manuelseraydarian followupandreasonsforextendedreleasenaltrexonediscontinuationforalcoholusedisorderafterhospitalinitiation AT jamesgasper followupandreasonsforextendedreleasenaltrexonediscontinuationforalcoholusedisorderafterhospitalinitiation AT trivenidefries followupandreasonsforextendedreleasenaltrexonediscontinuationforalcoholusedisorderafterhospitalinitiation |