Association Between Medication for Alcohol Use Disorder and Confirmed Linkage to Care Following Discharge From an Inpatient Unit for Medically Managed Withdrawal

Abstract

Background:

Patients with alcohol use disorder (AUD) frequently initiate their recovery by first completing treatment in an inpatient withdrawal management unit, but many are not connected to ongoing care after discharge. We sought to evaluate the correlation between the use of medications for AUD (MAUD) on confirmed linkage to care.

Methods:

We conducted a retrospective review of every patient admitted for alcohol withdrawal management to an American Society of Addiction Medicine Level IV unit for intensive inpatient withdrawal management from September 2021 to November 2022 to evaluate whether initiation or continuation of MAUD was associated with confirmed linkage to ongoing post-discharge addiction treatment. Data were collected via the institution’s electronic health record (EHR). Confirmed linkage was defined as having confirmation in the EHR for attending the planned follow-up appointment within 30 days of discharge. Statistically significant differences in unadjusted analyses were included in a logistic regression model to account for confounders.

Results:

There were 312 unique patient encounters. Fifty-three (17%) had their linkage confirmed, and 127 (40.7%) were discharged on MAUD. Among MAUDs, only extended-release naltrexone (XR-NTX) was associated with a greater likelihood of linkage (28.3% vs 10.8%, P = .001). In adjusted analyses, those receiving XR-NTX (adjusted odds ratio [aOR] 2.7, 95% confidence interval [CI] 1.3-5.6, P = .009) and drinks per drinking day prior to admission (aOR 0.96, 95% CI 0.92-0.99, P = .016) remained significant predictors of linkage to care.

Conclusions:

XR-NTX may enhance post-discharge care linkage. Further research is warranted to examine the potential role of MAUDs in improving AUD-related outcomes after the completion of inpatient treatment.