Discharge prescribing for alcohol use disorder remains low in hospitalized adults

Researchers examined adults hospitalized with an AUD-related diagnosis from 2018 to 2023 at two hospitals in one academic medical center. The retrospective cohort included 4,232 hospitalizations among 2,347 patients; neither hospital had a dedicated inpatient addiction medicine consultation service. The primary outcome was a new prescription for an FDA-approved medication for AUD at discharge. Multivariable analyses accounted for patients with multiple hospitalizations.

A new prescription was recorded in 467 hospitalizations (11%). A primary AUD diagnosis was the only patient-level factor associated with prescribing (odds ratio [OR] 1.25; 95% CI 1.02–1.54). Compared with stays of 0–2 days, stays of 3–4 days (OR 1.70; 95% CI 1.33–2.17) and 5–7 days (OR 1.47; 95% CI 1.08–2.02) were associated with higher prescribing; the association for stays of eight or more days was less certain (OR 1.37; 95% CI 0.98–1.91). Care-management consultation and discharge from general medicine teaching or family medicine services were also associated with prescribing.

The findings identify potential points for further study in efforts to improve inpatient treatment of AUD. Because this was an observational study at two hospitals, the associations do not establish that these factors cause higher prescribing or show which interventions would increase it.