Improving the utilisation of medication-assisted treatment for alcohol use disorder at discharge

Abstract

Alcohol use disorder is a constellation of symptoms and behaviours related to dependence and abuse. It is present in 11.0% of US adults and is a leading cause of death and healthcare expenditures in the USA. Medication-assisted treatment (MAT) is medication to reduce cravings, decrease rewards or limit withdrawal symptoms in combination with behavioural therapy. A review of all patients with an alcohol-related condition admitted to internal medicine teams at an academic medical centre over a 7-month period (N=583) identified that only 1.4% (n=8) were discharged with an MAT prescription. Quality improvement methods were used to increase the proportion of patients discharged with an MAT prescription. Implementing educational interventions and embedding a recommendation for MAT into the order sets used to treat alcohol withdrawal increased the percentage of patients with an alcohol-related condition that were discharged with an MAT prescription to 11.2%. MAT remains an underused intervention for the treatment of alcohol use disorder. However, combining educational and structural interventions, including just-in-time teaching, can successfully increase the percentage of patients who receive an MAT prescription.