[Thiamin and alcohol use disorder: A national survey of practice]

Therapie. 2020 May-Jun;75(3):281-294. doi: 10.1016/j.therap.2019.09.001. Epub 2019 Sep 9.
[Article in French]

Abstract

Objective: The survey aimed to estimate, in the presence of alcohol use disorder, the frequency of systematic prescription of thiamine, the factors associated with it, and those related to the administration (oral, intravenous, intramuscular) when Wernicke's encephalopathy is suspected.

Methods: A self-questionnaire available on Internet was sent by e-mail to doctors and nurses taking care patients with alcohol use disorder.

Results: In all, 565 professionals responded. The systematic prescription frequency of thiamine was 84.8 %, addiction care centers and medical-psychological centers prescribed it 5 times less than in psychiatric hospitals (OR=0.2 IC [0.1-0.5] P<0.0001), and medicine/surgery/obstetrics (MSO) services 10 times more than psychiatric hospitals (OR=10.7 IC [2.5-45.3] P<0.0001). The prescription decreased with the exercise period, the interns prescribing it 10 times more systematically (OR=10.9 IC [3.6-32.9] P<0.0001). In the presence of symptoms related to Wernicke's encephalopathy, thiamine administration was mainly oral (67.1 %). Intravenous administration was used more by the MSO services (OR=18.3 IC [10.2-32.7] P<0.0001), while the intramuscular injection was used more in psychiatric hospitals (OR=4.6 IC [1.7-11.9] P=0.0353).

Conclusion: The prescription of thiamine is rather systematic. In contrast, intravenous administration is underused, in the presence of symptoms related to Wernicke's encephalopathy, in favor of oral administration, and the more specific use of the intramuscular injection in psychiatry.

Keywords: Alcohol use disorder; Encéphalopathie de Gayet-Wernicke; Enquête; Survey; Thiamin prescribing; Thiamine; Trouble de l’usage d’alcool; Vitamin B1; Vitamine B1; Wernicke's encephalopathy.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Alcoholism / complications
  • Alcoholism / drug therapy*
  • Alcoholism / epidemiology
  • Clinical Competence / statistics & numerical data
  • Cross-Sectional Studies
  • Drug Administration Routes
  • Female
  • France / epidemiology
  • Geography
  • Humans
  • Male
  • Middle Aged
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Risk Factors
  • Substance Withdrawal Syndrome / drug therapy
  • Substance Withdrawal Syndrome / epidemiology
  • Surveys and Questionnaires
  • Thiamine / administration & dosage
  • Thiamine / therapeutic use*
  • Wernicke Encephalopathy / drug therapy
  • Wernicke Encephalopathy / epidemiology
  • Wernicke Encephalopathy / etiology

Substances

  • Thiamine