Alcohol and Alcoholism Advance Access originally published online on November 18, 2005
Alcohol and Alcoholism 2006 41(2):205; doi:10.1093/alcalc/agh239
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LETTER TO THE EDITOR
A POSSIBLE WAY TO MOTIVATE AMBIVALENT PATIENTS TO UNDERGO DETOXIFICATION
Alcohol Treatment Centre, Lausanne, Switzerland
* Author to whom correspondence should be addressed at: Alcohol Treatment Centre, Mont-Paisible 16, 1011 Lausanne CHUV, Switzerland. Tel.: +4121 314 08 75; Fax: +4121 314 05 62; E-mail: Jean-Bernard.Daeppen{at}chuv.ch
(Received 12 July 2005; first review notified 15 August 2005; in final revised form 19 September 2005; accepted 22 October 2005)
Health-related quality-of-life and well-being are two important outcome measures for inpatients attending alcohol treatment programs. Rapid improvement in well-being and health related quality-of-life may be a possible way to motivate ambivalent patients to undergo detoxification.
The present letter is an ancillary report of a randomized controlled trial on pharmacological management of alcohol withdrawal. It focuses on changes in patients' perception of well-being and health-related quality-of-life over the first 3 days of inpatient detoxification.
During a 12-month period, consecutive patients admitted to an alcohol treatment inpatient unit were considered for inclusion. The selection process was described in the principal report (Daeppen et al., 2002
). Subjects' well-being and perceived health-related quality of life were assessed at intake using four questions from the well-being schedule (McDowell and Newell, 1996) and three dimensions from the MOS-SF-36 (physical functioning, vitality, and mental health) (Ware and Sherbourne, 1992). Perceived well-being and health-related quality life were measured again at withdrawal day 4 using similar measures adapted to reflect the three first detoxification days. Wilcoxon tests were used to compare health-related measures between withdrawal days 1 and 4. Among the 126 included individuals, 4 left the programme within the first 3 days, 3 had exclusion criteria apparent only after inclusion, 1 had somnolence and 1 had several falls, resulting in a 117 (92.9 %) patient sample. The mean ± SD age was 46.6 ± 9.52 years; 76.9% were men (n = 90); 94.9% were white (n = 111).
Compared to withdrawal day 1, all mean scores were statistically improved at withdrawal day 4 toward a self-perception of a better functioning and health: health concerns score (3.72 vs 5.97, Z = –5.68, P < 0.001), anxiety score (3.84 vs 6.9, Z = –7.46, P < 0.001), energy score (5.43 vs 3.93, Z = –5.20, P < 0.001), feeling good vs. depressed score (6.12 vs 3.9, Z = –7.06, P < 0.001), physical functioning (MOS-SF-36) (87.91 vs 84.30, Z = –4.08, P < 0.001), vitality (MOS-SF-36) (57.61 vs 42.87, Z = –6.85, P < 0.001), and mental health (MOS-SF-36) (66.99 vs 46.26, Z = –7.91, P < 0.001).
This letter suggests rapid improvement in all examined dimensions of perceived well-being and health-related quality of life over the first 3 days of alcohol withdrawal among alcohol-dependent individuals. The data reported are consistent with observations on perceived health-related quality-of-life associated with abstinence published in the literature (Foster et al., 1999). These findings may be used as a motivational tool to encourage alcohol-dependent patients to undergo detoxification and as positive feedback for patients' during early alcohol withdrawal.
REFERENCES
Daeppen, J. B., Gache, P., Landry, U. et al. (2002) Symptom-triggered vs. fixed-schedule doses of benzodiazepine for alcohol withdrawal: a randomised treatment trial. Archives of Internal Medicine 162, 1117–1121.
Foster, J. H., Powell, J. E., Marshall, E. J. et al. (1999) Quality of life in alcohol-dependent subjects : a review. Quality of Life Research 8, 255–261.
McDowell, I. and Newell, C. (1996) The general well-being schedule. In Measuring Health: A Guide to Rating Scales and Questionnaires, 2nd edn, pp. 206–213. Oxford University Press, Oxford.
Ware, J.E., Jr and Sherbourne, C. D. (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care 30, 473–483.[ISI][Medline]
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