Effectiveness of a nurse led hospital in-reach team and assertive follow-up of frequent attenders with alcohol misuse complications – a retrospective mirror image evaluation

First published: 10/05/2019 | Last updated: May 20th, 2019

Aims

To evaluate the effect of hospital in-reach team of the Leeds Addiction Unit (LAU) in reducing hospital service utilization in people with alcohol dependence.

Design

This is a retrospective cohort study, with a mirror-image design where patients on treatment act as their own control. We included all patients who had wholly alcohol attributable admission(s) to Leeds Teaching Hospitals during a four-month period between Jan – April 2013 and received treatment from LAU.

Setting

Community specialist alcohol treatment in Leeds Addiction Unit.

Participants and intervention

There was no change in the usual treatment and the data was collected retrospectively from electronic and paper notes.

Measurements

The primary outcome measures were changes in the number of hospital admissions and number of days in hospital between 3 months after and 3 months before the intervention.

Findings

– There were 1,711 wholly alcohol attributable admissions related to 1,145 patients (Mean hospital admissions = 1.49, Mean hospital days= 5.7).

– LAU saw 286 patients in at least during one of their admissions. Of 64 who engaged in treatment 50 had wholly alcohol attributable admissions.

– 35 (54.7%) of these 50 patients had fewer admissions in the 3 months after and 40 (62.5%) spent fewer days in hospital.

– There was a significant reduction in total admissions (78 vs 41, P<0.001) and hospital days (490 vs 146, P<0.001) after 3 months LAU intervention.

Conclusions

This mirror-image study shows that patients who engaged in treatment with LAU had a reduction in the number of admissions and number of days in hospital.

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Dr Jamshid Nazari