Assessing the revised clinical institute withdrawal for alcohol scale (CIWA-Ar) use at Stikland Hospital

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Stellenbosch : Stellenbosch University
ENGLISH SUMMARY: Background: Alcohol use disorder is a major public health concern in South Africa. Abrupt cessation or reduction of alcohol intake in the chronic user can result in withdrawal symptoms. Benzodiazepines are recognised as the treatment of choice but need to be used cautiously in patients with a lifetime history of substance abuse given their highly addictive potential. Symptom-triggered prescription of benzodiazepines during alcohol withdrawal using the Revised Clinical Institute Withdrawal for Alcohol Scale (CIWA-Ar) has been associated with improved safety and reduced benzodiazepines use. Aim: To investigate if implementation of the CIWA-Ar during alcohol detoxification impacted the amount of benzodiazepines used and withdrawal-related outcomes in a specialized alcohol rehabilitation unit at Stikland Psychiatric Hospital in the Western Cape, South Africa. Methods: We conducted a retrospective cohort study of 135 admissions over a six month period before (2015) and after (2017) implementation of the CIWA-Ar. Results: We noted no differences in sociodemographic and alcohol-associated variables at admission between the two groups and there were no recorded complications in either group. The 2017 group had a lower percentage of patients that required benzodiazepines (33.8% vs 51.4%, p=0.04) and a lower median total amount of benzodiazepines used during alcohol withdrawal (0mg vs 5mg, p=0.01). Conclusions: The findings indicate that using the CIWA-Ar rating scale to determine benzodiazepines requirements in the specialised alcohol rehabilitation unit was a safe and effective alternative to pro re nata benzodiazepines prescribing in the South African setting and decreased the amount of benzodiazepines used during alcohol withdrawal.
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.
Thesis (MMed)--Stellenbosch University, 2022.
Alcohol withdrawal syndrome -- Cape Town (South Africa), Substance abuse -- Treatment -- Cape Town (South Africa), Alcoholism -- Treatment -- Cape Town (South Africa), UCTD