Quality statement 9: Medically assisted alcohol withdrawal – drug regimens

Quality statement

People needing medically assisted alcohol withdrawal receive medication using drug regimens appropriate to the setting in which the withdrawal is managed in accordance with NICE guidance.

Quality measure

Structure: Evidence of local arrangements to ensure that people undergoing medically assisted alcohol withdrawal are prescribed medication that is administered using drug regimens in accordance with NICE's guidelines on alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence and alcohol-use disorders: diagnosis and management of physical complications.

Process:

a) Proportion of people undergoing planned medically assisted alcohol withdrawal who receive medication using drug regimens in accordance with NICE's guideline on alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence.

Numerator – the number of people in the denominator receiving medication using drug regimens in accordance with NICE's guideline on alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence.

Denominator – the number of people undergoing medically assisted alcohol withdrawal.

b) Proportion of people in acute (unplanned) alcohol withdrawal who receive medication using drug regimens in accordance with NICE's guideline on alcohol-use disorders: diagnosis and management of physical complications.

Numerator – the number of people in the denominator receiving medication using drug regimens in accordance with NICE's guideline on alcohol-use disorders: diagnosis and management of physical complications.

Denominator – the number of people in acute (unplanned) alcohol withdrawal.

Outcome: Proportion of people undergoing medically assisted alcohol withdrawal (planned or unplanned) who complete withdrawal successfully and without complications.

Numerator – the number of people in the denominator completing medically assisted withdrawal successfully and without complications.

Denominator – the number of people undergoing medically assisted alcohol withdrawal (planned or unplanned).

What the quality statement means for each audience

Service providers ensure that people undergoing planned medically assisted alcohol withdrawal are prescribed medication that is administered using drug regimens in accordance with NICE's guideline on alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence and people in acute (unplanned) withdrawal are prescribed medication that is administered using drug regimens in accordance with NICE's guideline on alcohol-use disorders: diagnosis and management of physical complications.

Healthcare professionals caring for people undergoing planned medically assisted alcohol withdrawal ensure they use drug regimens in accordance with NICE's guideline on alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence and, for people in acute (unplanned) withdrawal, use drug regimens in accordance with NICE's guideline on alcohol-use disorders: diagnosis and management of physical complications.

Commissioners ensure they commission services for planned medically assisted alcohol withdrawal that use drug regimens in accordance with NICE's guideline on alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence and for people in acute (unplanned) withdrawal, that use drug regimens in accordance with NICE's guideline on alcohol-use disorders: diagnosis and management of physical complications.

People undergoing medically assisted alcohol withdrawal are given medication in a manner (frequency and amount) determined by the place where withdrawal is carried out.

Source guidance

Data source

Structure: Local data collection.

Process:

a) Local data collection.

b) Local data collection.

NHS Digital's Statistics on alcohol in England reports on items prescribed for the treatment of alcohol dependence, including the setting in which they are prescribed.

Outcome: Local data collection. The International statistical classification of diseases and related health problems (ICD-10) code for alcohol withdrawal state with delirium is F10.4.

Definitions

All prescribing for medically assisted alcohol withdrawal should be carried out in accordance with NICE's guideline on alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence, section 1.3.5, recommendation 1.3.7.6, and NICE's guideline on alcohol-use disorders: diagnosis and management of physical complications, recommendations 1.1.3.1 and 1.1.3.4 on drug regimens for assisted withdrawal.

Prescribers should use each drug's summary of product characteristics (SPC) with regard to current licensed indications, contraindications and special considerations to inform their decision about a person they are prescribing for. If a drug is used at a dose or for an application that does not have UK marketing authorisation, informed consent should be obtained and documented.