{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T07:05:22Z","timestamp":1760598322871,"version":"3.44.0"},"reference-count":18,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2024,12,9]],"date-time":"2024-12-09T00:00:00Z","timestamp":1733702400000},"content-version":"unspecified","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Qual"],"accepted":{"date-parts":[[2024,11,20]]},"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:p>Only 1.9% of the individuals in the USA with alcohol use disorder (AUD) receive medication for AUD. Hospitalisation presents an opportunity to identify patients with AUD and offer treatment. Extended-release naltrexone (XR-NTX) is a Food and Drug Administration-approved medication for AUD that reduces drinking days and heavy drinking days. XR-NTX can reduce healthcare costs, decrease acute care utilisation and increase retention in treatment. We offered and initiated XR-NTX during hospitalisation to patients with moderate-to-severe AUD. We describe the follow-up rates for XR-NTX after hospital initiation and the reasons for XR-NTX discontinuation in the outpatient setting after hospital initiation. We performed a retrospective chart review of 62 hospitalised patients with moderate-to-severe AUD who received XR-NTX between 1 November 2019 and 31 December 2020. Twenty-two patients (35.5%) received \u22651\u2009dose of XR-NTX within the first 3 months of discharge, 22 (35.5%) stopped XR-NTX and 18 (29.0%) did not follow-up. Overall, 44 (71.0%) patients followed up after discharge. Among those that discontinued XR-NTX, the most common reasons were: (1) a preference for oral NTX; (2) clinicians switching patients to oral NTX after patients missed an XR-NTX dose; (3) clinician challenges in prescribing XR-NTX; and (4) patient obstacles to accessing outpatient care. Our study highlights several opportunities to address modifiable reasons to improve access to and retention in XR-NTX treatment.<\/jats:p>","DOI":"10.1136\/bmjoq-2024-003113","type":"journal-article","created":{"date-parts":[[2024,12,9]],"date-time":"2024-12-09T20:56:53Z","timestamp":1733777813000},"page":"e003113","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Follow-up and reasons for extended-release naltrexone discontinuation for alcohol use disorder after hospital initiation"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8727-0289","authenticated-orcid":false,"given":"Marlene","family":"Martin","sequence":"first","affiliation":[{"name":"Department of Medicine, San Francisco General Hospital, San Francisco, California, USA"},{"name":"Department of Medicine, University of California San Francisco, San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6604-5656","authenticated-orcid":false,"given":"Manuel","family":"Seraydarian","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, San Francisco General Hospital, San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Gasper","sequence":"additional","affiliation":[{"name":"San Francisco General Hospital and Trauma Center, San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Triveni","family":"DeFries","sequence":"additional","affiliation":[{"name":"Department of Medicine, San Francisco General Hospital, San Francisco, California, USA"},{"name":"Department of Medicine, University of California San Francisco, San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,12,9]]},"reference":[{"key":"2025083111171594000_13.4.e003113.1","unstructured":"Key substance use and mental health indicators in the united states: results from the 2023 national survey on drug use and health. 2023."},{"key":"2025083111171594000_13.4.e003113.2","unstructured":"ARDI alcohol-attributable deaths,US. 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