{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T14:41:49Z","timestamp":1780324909244,"version":"3.54.1"},"reference-count":31,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,8,11]],"date-time":"2023-08-11T00:00:00Z","timestamp":1691712000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine if a novel symptom\u2010based alcohol withdrawal syndrome (AWS) protocol in a US Veterans cohort leads to significant clinical improvements in patient outcomes and safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Prior studies of AWS management, oftentimes using the revised version of the Clinical Institute Withdrawal Assessment for Alcohol (CIWA\u2010Ar) index, have demonstrated the effectiveness of symptom\u2010triggered therapy for AWS. The Minnesota Detoxification Scale (MINDS) is an alternative to the CIWA\u2010Ar index but remains unevaluated outside of the intensive care unit (ICU) setting. This study assesses outcomes in AWS management prior to and after the implementation of a novel MINDS\u2010based AWS protocol (SDAWP) utilizing a revised MINDS index (MINDS\u2010rev) in an inpatient medical ward setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Retrospective cohort study including encounters prior to (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009342) and after (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009338) the implementation of the protocol. Pre\u2010 and post\u2010protocol encounters were selected by combinations of diagnostic codes and charting elements. Outcome measures of AWS management were obtained in both groups. The primary endpoint was median total benzodiazepine exposure. Secondary outcomes included median length of hospitalization, median duration of benzodiazepine administration, and the incidence of complications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median total benzodiazepine exposure in the post\u2010SDAWP group was significantly lower than the pre\u2010SDAWP group (21.2 vs. 12.0\u2009mg,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001) and for a significantly shorter median duration of time (4.0 vs. 3.0\u2009days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). There was no significant difference in the median length of stay (4.0 vs. 4.0\u2009days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.50). The incidence of delirium tremens (21 vs. 7,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01) and need for transfer to a higher level of care (33 vs. 12,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) was significantly lower in the post\u2010SDAWP group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The SDAWP has provided significant improvements in AWS management in our institution and may potentially serve as a template for wider use in other inpatient settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/phar.2855","type":"journal-article","created":{"date-parts":[[2023,7,21]],"date-time":"2023-07-21T01:49:28Z","timestamp":1689904168000},"page":"1297-1306","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Assessment of a modified\n                    <scp>MINDS<\/scp>\n                    \u2010based protocol for management of alcohol withdrawal syndrome on an inpatient medical service"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2590-907X","authenticated-orcid":false,"given":"Kevin M.","family":"Krcmarik","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Section of Hospitalist Medicine Jennifer Moreno Veterans Affairs Medical Center  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin J.","family":"Hulley","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Hospitalist Medicine Jennifer Moreno Veterans Affairs Medical Center  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiayi","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Jennifer Moreno Veterans Affairs Medical Center  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek","family":"Juang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Hospitalist Medicine Jennifer Moreno Veterans Affairs Medical Center  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Cadman","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Hospitalist Medicine Jennifer Moreno Veterans Affairs Medical Center  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charisma","family":"Urbiztondo","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Jennifer Moreno Veterans Affairs Medical Center  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Vo","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Jennifer Moreno Veterans Affairs Medical Center  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaclyn","family":"Vargas","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Hospitalist Medicine Jennifer Moreno Veterans Affairs Medical Center  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramin","family":"Motarjemi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Hospitalist Medicine Jennifer Moreno Veterans Affairs Medical Center  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarlan","family":"Moinizandi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Hospitalist Medicine Jennifer Moreno Veterans Affairs Medical Center  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Kwan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Hospitalist Medicine Jennifer Moreno Veterans Affairs Medical Center  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.alcohol.2014.01.004"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2015.05.031"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.13423"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ALC.0000067980.18461.33"},{"key":"e_1_2_8_6_1","unstructured":"MillerJ.US Military Veterans and Addiction.2021. weblink:https:\/\/wwwaddictionhelpcom\/addiction\/veterans\/February 23 2023"},{"key":"e_1_2_8_7_1","unstructured":"SAMHSA.Veterans primary substance of abuse is alcohol in treatment admissions: the CBHSQ report.2011. weblink:https:\/\/wwwsamhsagov\/data\/sites\/default\/files\/report_2111\/Spotlight\u20102111htmlNovember 10 2015"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1310\/hpj5109-752"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-7125(05)70554-X"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.12529"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.2007.00421.x"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ta.0000245981.22931.43"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1592\/phco.27.4.510"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2017.02.009"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/phar.2127"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocpiqo.2019.06.005"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.4065\/76.7.695"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.12968\/bjon.2014.23.4.198"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/1060028016672036"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1592\/phco.23.7.843.32719"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/10884600701699255"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1310\/hpj4410-881"},{"key":"e_1_2_8_23_1","first-page":"199","article-title":"Assessment of pharmacological treatment quality: comparison of symptom\u2010triggered vs. fixed\u2010schedule alcohol withdrawal in clinical practice","volume":"5","author":"M\u00fcller UJ","year":"2016","journal-title":"Pharmacopsychiatry"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.12932"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1994.03520070039035"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1080\/10550490050173208"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/alcalc\/agt181"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.162.10.1117"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2017.1354119"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/alcalc\/agad016"},{"key":"e_1_2_8_31_1","first-page":"100","article-title":"Clinical management of alcohol withdrawal: a systematic review","volume":"2","author":"Kattimani S","year":"2013","journal-title":"Ind Psychiatry J"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.4037\/ajcc2018547"}],"container-title":["Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/phar.2855","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T17:52:39Z","timestamp":1761069159000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1002\/phar.2855"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,11]]},"references-count":31,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1002\/phar.2855"],"URL":"https:\/\/doi.org\/10.1002\/phar.2855","archive":["Portico"],"relation":{},"ISSN":["0277-0008","1875-9114"],"issn-type":[{"value":"0277-0008","type":"print"},{"value":"1875-9114","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,11]]},"assertion":[{"value":"2023-03-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}