Remote Treatment of Alcohol Withdrawal
Remote Treatment of Alcohol Withdrawal: A Pilot Study
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Emily Simpkin, RN
- Phone Number: 30777 416-535-8501
- Email: emily.simpkin@camh.ca
Study Locations
-
-
Ontario
-
Toronto, Ontario, Canada, M6J 1H4
- Centre for Addiction and Mental Health
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Adults 18 years and older
- Are actively using alcohol
- Previously met Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) B criteria for alcohol withdrawal
- Aim to achieve at least 30 days of abstinence as a treatment goal following initiation of remote alcohol withdrawal management
- Are able to provide informed consent in English.
- Reside or are able to stay at an address within 2-hours travelling distance from the Centre for Addiction and Mental Health for the entire duration of the remote withdrawal procedure
- Are enrolled in the Ontario Health Insurance Plan (OHIP)
Exclusion Criteria:
- History of complicated withdrawal including withdrawal seizures, hallucinosis, or delirium
- Positive UDS for sedatives or opioids, currently prescribed sedatives or opioids, or diagnosis of sedative-hypnotic or opioid use disorder within the past year (based on assessment). Individuals prescribed low doses of benzodiazepines (e.g. lorazepam 1mg PO daily) or with a positive urine benzodiazepine screen that is not thought to be due to benzodiazepine misuse may be permitted to proceed with the study at the discretion of the study physician.
- Severe medical or psychiatric comorbidity that would prevent safe participation in the study
- Contraindications to the safe use of diazepam including: known hypersensitivity to diazepam severe respiratory insufficiency, severe hepatic insufficiency, sleep apnea syndrome, acute narrow-angle glaucoma, and myasthenia gravis. Individuals with sleep apnea may be permitted to proceed with the study at the discretion of the study physician.
- Active withdrawal symptoms (CIWA-Ar > 12) at the time of the eligibility assessment
- Active suicidal ideation at the time of eligibility assessment
- Positive urine pregnancy test, actively breastfeeding, or planning to become pregnant or breastfeed during the study period
- Lack of stable housing
- Enrollment in another study that conflicts with the procedures or scientific integrity of this study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Symptom-triggered diazepam treatment
Participants will be treated for a period of 3 days using a symptom-triggered withdrawal management protocol delivered over telemedicine.
Participants who score 10 or above on the modified CIWA-Ar will be advised to take a specific dose of diazepam (either 10 or 20mg, at the clinician's discretion).
Participants will be reassessed regularly over the 3-day period.
|
Symptom-triggered diazepam treatment: 10 or 20mg, at the clinician's discretion
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Retention in Treatment
Time Frame: 3-5 day treatment period
|
Retention in treatment, as measured by the percentage of participants who complete the entire 3-day remote withdrawal management protocol.
|
3-5 day treatment period
|
|
Transfer to a Higher Level of Care
Time Frame: 3-5 day treatment period
|
Transfer to a higher level of care, as measured by the percentage of participants sent to the emergency room due to complications, need for intensive monitoring, or acute intoxication.
If ≤ 20%, of participants require transfer to a higher level of care, we will consider this as additional evidence of feasibility.
|
3-5 day treatment period
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Patient Satisfaction With the Treatment Protocol
Time Frame: Measured within 1 week of completing the remote withdrawal procedure
|
Satisfaction with the overall treatment protocol, measured with the Client Satisfaction Questionnaire-8 (minimum score = 8; maximum score = 32; higher score indicates greater client satisfaction).
|
Measured within 1 week of completing the remote withdrawal procedure
|
|
Patient Satisfaction With the Telemedicine Platform
Time Frame: Measured within 1 week of completing the remote withdrawal procedure
|
Satisfaction with the telemedicine platform, measured with a modified version of the Telehealth Satisfaction Scale (minimum score = 12; maximum score = 48; higher score indicates greater satisfaction with the telemedicine platform).
|
Measured within 1 week of completing the remote withdrawal procedure
|
|
Duration of Active Withdrawal Treatment
Time Frame: 3-5 day treatment period
|
Duration of active withdrawal treatment, as measured by the number of days that patients received diazepam among patients who received benzodiazepines.
|
3-5 day treatment period
|
|
Requirement of Benzodiazepines
Time Frame: 3-5 day treatment period
|
Benzodiazepines requirement, as measured by the percentage of participants requiring benzodiazepine treatment.
|
3-5 day treatment period
|
|
Diazepam Dose
Time Frame: 3-5 day treatment period
|
Diazepam dose, as measured by the average dose of diazepam required to control symptoms among patients who received diazepam.
|
3-5 day treatment period
|
|
Withdrawal Severity
Time Frame: 3-5 day treatment period
|
Withdrawal severity, as measured by the average peak Clinical Institute Withdrawal Assessment for Alcohol Scale, revised score measured over the treatment period (minimum score = 0; maximum score = 67; higher score indicates greater withdrawal severity).
|
3-5 day treatment period
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Matthew Sloan, MD, MSc, Centre for Addiction and Mental Health
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 137/2020
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Alcohol Withdrawal
-
NCT01573052CompletedAlcohol Withdrawal
-
NCT01362205TerminatedAlcohol Withdrawal Delirium | Alcohol Withdrawal Associated Autonomic Hyperactivity | Alcohol Withdrawal Hallucinosis | Alcohol Withdrawal-Induced Delirium Tremens
-
NCT02823977WithdrawnAlcohol Withdrawal
-
NCT00523185Completed
-
NCT03586089TerminatedAlcohol Withdrawal | Alcohol Withdrawal Delirium | Alcohol Withdrawal Seizures
-
NCT05131334CompletedPsychophysiologic Reaction | Alcohol Withdrawal
-
NCT04973202CompletedAddiction | Alcohol Use Disorder | Alcohol Withdrawal Syndrome
-
NCT02090504CompletedAlcohol Dependence | Alcohol Withdrawal Syndrome
Clinical Trials on Diazepam
-
NCT06293989Not yet recruiting
-
NCT00211276Completed
-
NCT01696825Terminated
-
NCT03080259Completed
-
NCT02474407Terminated
-
NCT03428360Completed
-
NCT01675648CompletedOpiate Dependent Patients Who Are Undergoing Inpatient Detoxification in Singapore
-
NCT00586820CompletedMyocardial Reperfusion Injury