Hospital-Wide Implementation, Clinical Outcomes, and Safety of Phenobarbital for Alcohol Withdrawal

Is implementing a phenobarbital electronic health record order set across all care locations of a community hospital associated with improved outcomes for alcohol withdrawal syndrome (AWS)?In this quality improvement study comparing outcomes before (154 patients) and after (100 patients) implementation, 67% of postimplementation patients were treated using the phenobarbital order set, which was associated with faster symptom resolution (4.2- to 5.0-point Clinical Institute Withdrawal Assessment of Alcohol Scale Revised score reduction from 24-96 hours), reduced AWS treatment duration (30.1 hours), shorter hospital stay (2.2 days), and no increase in adverse events.These findings suggest that hospital-wide use of a phenobarbital order set is safe and effective for treating AWS and is associated with shortened symptom duration and length of stay.

Corresponding Author: Benjamin J. Wolpaw, MD, Division of General Internal Medicine, Department of Medicine, University of Washington, 1530 N 115th St, Ste 301, Box 358813, Seattle, WA 98133 (benjow@uw.edu).

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