Influence of inpatient withdrawal treatment on drug safety in alcohol use disorder — a quasi-experimental pre-post study

Abstract

Abstract Objective Most patients with alcohol use disorder (AUD) regularly take medication. Alcohol interacts negatively with many commonly prescribed medications. Little is known about whether the risk of potential alcohol-medication and drug-drug interactions increases or decreases in patients with AUD during inpatient withdrawal treatment. The aim of our study was to determine the prevalence and characteristics of potential alcohol-medication and drug-drug interactions in patients with AUD before and after withdrawal treatment in an addiction unit. Design Prospective monocentric quasi-experimental pre-post study. Methods Medication records before and after withdrawal treatment were analyzed and screened for potential alcohol-medication (pAMI) and drug-drug interactions (pDDI) using the drugs.com classification and the AiDKlinik ® electronic interaction program, respectively. Results We enrolled 153 patients with AUD who were treated in an addiction unit of a university hospital in Germany. Of these, 67.3% experienced at least one pAMI before and 91.5% after withdrawal treatment. In total, there were 278 pAMIs classified as “mild,” “moderate,” or “severe” before and 370 pAMIs after withdrawal treatment. Additionally, there were 76 pDDIs classified as “moderate,” “severe,” or “contraindicated combinations” both before and after withdrawal treatment. Conclusion The risk of exposure to pAMIs and pDDIs increases during inpatient withdrawal treatment in patients with AUD. Improvements in the quality of prescribing should particularly focus on the use of antihypertensives and opioids.

Keywords

• Alcohol use disorder
• Drug safety
• Alcohol–medication interactions
• Potentially inappropriate medications
• Drug–drug interactions