Impact of psychiatric pharmacist-led ambulatory alcohol withdrawal management
Introduction Alcohol withdrawal syndrome (AWS) is a complication of alcohol use disorder commonly encountered across various healthcare settings. Management of AWS is routinely conducted in the inpatient setting; however, in numerous patients, ambulatory alcohol withdrawal management (AAWM) is safe,...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
American Association of Psychiatric Pharmacists
2025-06-01
|
| Series: | Mental Health Clinician |
| Subjects: | |
| Online Access: | https://theijpt.org/doi/pdf/10.9740/mhc.2025.06.170 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849434237803954176 |
|---|---|
| author | Maxwell Lamb, PharmD, BCPS Michelle Colvard, PharmD, BCPP Jonathan Lister, PharmD, BCPP Eric Johnson, PharmD, BCPP |
| author_facet | Maxwell Lamb, PharmD, BCPS Michelle Colvard, PharmD, BCPP Jonathan Lister, PharmD, BCPP Eric Johnson, PharmD, BCPP |
| author_sort | Maxwell Lamb, PharmD, BCPS |
| collection | DOAJ |
| description | Introduction
Alcohol withdrawal syndrome (AWS) is a complication of alcohol use disorder commonly encountered across various healthcare settings. Management of AWS is routinely conducted in the inpatient setting; however, in numerous patients, ambulatory alcohol withdrawal management (AAWM) is safe, effective, and recommended. There is no published evidence describing psychiatric pharmacists, otherwise known as Psychiatric Clinical Pharmacist Practitioners (psychiatric-CPP) impact on AAWM.
Methods
This was a single-centered, retrospective review conducted at a Veterans Affairs Healthcare System that aimed to quantify and describe the clinical impact of psychiatric-CPP–led AAWM. Veterans who participated in AAWM with a psychiatric-CPP from April 1, 2019, to December 31, 2023, were included in the study. Descriptive statistics were used.
Results
The rate of successful AAWM was 67.6% (n = 23) for 34 total withdrawal episodes. The most common reason for failure was breakthrough withdrawal or cravings at 45.5% (n = 5). The most common medications utilized included gabapentin (62.9%; n = 22), chlordiazepoxide (8.6%; n = 3), and diazepam (8.6%; n = 3). In 3 AAWM episodes, no medications were used. Cost avoidance of outpatient management rather than inpatient management was calculated to be $139,361.24. There were 2 alcohol-related emergency department visits within the first month of psychiatric-CPP–conducted AAWM, and no serious medical complications were noted.
Discussion
Psychiatric-CPPs practicing in a Veterans Affairs Healthcare System successfully completed AAWM in a majority of the episodes that were attempted. Additionally, few patients were seen in an emergency department setting for alcohol-related matters after initiation of AAWM, perhaps emphasizing the safety of this service and the need for further use. |
| format | Article |
| id | doaj-art-eeda4e4bac864c3cabfb6fa2cecb3617 |
| institution | Kabale University |
| issn | 2168-9709 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | American Association of Psychiatric Pharmacists |
| record_format | Article |
| series | Mental Health Clinician |
| spelling | doaj-art-eeda4e4bac864c3cabfb6fa2cecb36172025-08-20T03:26:43ZengAmerican Association of Psychiatric PharmacistsMental Health Clinician2168-97092025-06-0115317017510.9740/mhc.2025.06.170i2168-9709-15-3-170Impact of psychiatric pharmacist-led ambulatory alcohol withdrawal managementMaxwell Lamb, PharmD, BCPS0https://orcid.org/0009-0009-2476-7779Michelle Colvard, PharmD, BCPP1https://orcid.org/0000-0002-5718-5013Jonathan Lister, PharmD, BCPP2https://orcid.org/0000-0002-6493-7420Eric Johnson, PharmD, BCPP3https://orcid.org/0009-0007-2833-444X1 (Corresponding author) Mental Health Clinical Pharmacy Specialist, Carl Vinson Veterans Affairs Medical Center, Dublin, Georgia2 Substance Use Disorder Clinical Pharmacist Practitioner, Veterans Affairs Tennessee Valley Healthcare System, Nashville, Tennessee3 Mental Health Clinical Pharmacist Practitioner, Veterans Affairs Tennessee Valley Healthcare System, Nashville, Tennessee4 Mental Health Clinical Pharmacist Practitioner, Veterans Affairs Tennessee Valley Healthcare System, Murfreesboro, TennesseeIntroduction Alcohol withdrawal syndrome (AWS) is a complication of alcohol use disorder commonly encountered across various healthcare settings. Management of AWS is routinely conducted in the inpatient setting; however, in numerous patients, ambulatory alcohol withdrawal management (AAWM) is safe, effective, and recommended. There is no published evidence describing psychiatric pharmacists, otherwise known as Psychiatric Clinical Pharmacist Practitioners (psychiatric-CPP) impact on AAWM. Methods This was a single-centered, retrospective review conducted at a Veterans Affairs Healthcare System that aimed to quantify and describe the clinical impact of psychiatric-CPP–led AAWM. Veterans who participated in AAWM with a psychiatric-CPP from April 1, 2019, to December 31, 2023, were included in the study. Descriptive statistics were used. Results The rate of successful AAWM was 67.6% (n = 23) for 34 total withdrawal episodes. The most common reason for failure was breakthrough withdrawal or cravings at 45.5% (n = 5). The most common medications utilized included gabapentin (62.9%; n = 22), chlordiazepoxide (8.6%; n = 3), and diazepam (8.6%; n = 3). In 3 AAWM episodes, no medications were used. Cost avoidance of outpatient management rather than inpatient management was calculated to be $139,361.24. There were 2 alcohol-related emergency department visits within the first month of psychiatric-CPP–conducted AAWM, and no serious medical complications were noted. Discussion Psychiatric-CPPs practicing in a Veterans Affairs Healthcare System successfully completed AAWM in a majority of the episodes that were attempted. Additionally, few patients were seen in an emergency department setting for alcohol-related matters after initiation of AAWM, perhaps emphasizing the safety of this service and the need for further use.https://theijpt.org/doi/pdf/10.9740/mhc.2025.06.170ambulatory alcohol withdrawaloutpatient alcohol withdrawalalcohol withdrawal managementpsychiatric pharmacistmental health pharmacistveterans affairs |
| spellingShingle | Maxwell Lamb, PharmD, BCPS Michelle Colvard, PharmD, BCPP Jonathan Lister, PharmD, BCPP Eric Johnson, PharmD, BCPP Impact of psychiatric pharmacist-led ambulatory alcohol withdrawal management Mental Health Clinician ambulatory alcohol withdrawal outpatient alcohol withdrawal alcohol withdrawal management psychiatric pharmacist mental health pharmacist veterans affairs |
| title | Impact of psychiatric pharmacist-led ambulatory alcohol withdrawal management |
| title_full | Impact of psychiatric pharmacist-led ambulatory alcohol withdrawal management |
| title_fullStr | Impact of psychiatric pharmacist-led ambulatory alcohol withdrawal management |
| title_full_unstemmed | Impact of psychiatric pharmacist-led ambulatory alcohol withdrawal management |
| title_short | Impact of psychiatric pharmacist-led ambulatory alcohol withdrawal management |
| title_sort | impact of psychiatric pharmacist led ambulatory alcohol withdrawal management |
| topic | ambulatory alcohol withdrawal outpatient alcohol withdrawal alcohol withdrawal management psychiatric pharmacist mental health pharmacist veterans affairs |
| url | https://theijpt.org/doi/pdf/10.9740/mhc.2025.06.170 |
| work_keys_str_mv | AT maxwelllambpharmdbcps impactofpsychiatricpharmacistledambulatoryalcoholwithdrawalmanagement AT michellecolvardpharmdbcpp impactofpsychiatricpharmacistledambulatoryalcoholwithdrawalmanagement AT jonathanlisterpharmdbcpp impactofpsychiatricpharmacistledambulatoryalcoholwithdrawalmanagement AT ericjohnsonpharmdbcpp impactofpsychiatricpharmacistledambulatoryalcoholwithdrawalmanagement |