Alcohol Dependence
Conditions
Keywords
Detoxification, Outpatient, Advanced Nursing, Health Services
Brief summary
The SAMBA study aims to assess the safety and cost comparison of the management of outpatient alcohol detoxification, between an advanced nurse protocol on the one hand (experimental group), and a GP-based treatment on the other hand (standard-of-care group). In the advanced nurse (AN) group, nurses manage alcohol detox using a predefined protocol based on both the Cushman and CIWA-Ar scales. Depending on the Cushman and CIWA-Ar scores, which are calculated at every consultation, advanced nurse can adjust the diazepam dosing. In case of any serious adverse event or uncontrolled withdrawal complication, an addiction specialist stands in back-up and can be appealed to decide whether the outpatient detox can be continued or whether the patient has to be hospitalized. In the GP group, GPs can manage patients as they wish.
Interventions
PROCEDUREAdvanced Nurse (AN)
Protocoled AN-based management of detox
PROCEDUREGeneral Practitioner (GP)
'As usual' medical management of detox
Sponsors
Ministry of Health, France
University Hospital, Lille
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 64 Years
Healthy volunteers
No
Inclusion criteria
* DSM-IV-Tr criteria for alcohol dependence * Clinical indication for alcohol detoxification * Social Insurance * Signed Consent Form for participation
Exclusion criteria
* Previous history of seizures * previous history of delirium tremens * acute or chronic liver failure * contraindication for using diazepam * average daily alcohol use of 300g of ethanol * SADQ score of 30 or more * chronic treatment with baclofen or disulfiram * current DMS-IV-Tr criteria for major depressive episode, or lifelong history of bipolar or psychotic disorder * any physical, cognitive, or psychiatric disorder that expose the subjects to enhanced risks (at the discretion of the investigator) * previous participation in the SAMBA study * social isolation of homelessness (at the discretion of the investigator) * pregnancy or breastfeeding * guardianship or curatorship * previous participation in a biomedical study over the previous month
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of patients considered in failure of outpatient alcohol detoxification period | 15 days | Hospitalization required (any cause) across the 15 days following the detox start |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The total costs for each arm by cost-minimization | during the 15 days of the outpatient alcohol detoxification | All medical costs (visits, medications, hospitalizations, ambulance,..) resulting from the detoxification management |
| Number of patients reporting at least one recovery in alcohol consumption | during the 15 days of the outpatient alcohol detoxification | alcohol consumption obtained from A-TLFB data |
| Number of patients reporting at least one high alcohol intake | during the 15 days of the outpatient alcohol detoxification | High alcohol intake defined by consumption of more than 5 standard drinks per day |
| Number of patients with adverse events | during the 15 days of the outpatient alcohol detoxification | — |
Countries
France
Outcome results
None listed