Evidence map›Paper›PMID 36419181›Full record

Trial reportAddiction science & clinical practice2022

Single-dose intravenous ketamine or intramuscular naltrexone for high-utilization inpatients with alcohol use disorder: pilot trial feasibility and readmission rates.

Dale Terasaki, Ryan Loh, Anastasia Cornell, Julie Taub, Christian Thurstone

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Addiction science & clinical practice, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04562779 (Single-dose Interventions to Reduce Re-admissions for Hospitalized Patients With Refractory Alcohol Use Disorder), which is not on this map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
3.7field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04562779 early_phase1completednot on this map

Single-dose Interventions to Reduce Re-admissions for Hospitalized Patients With Refractory Alcohol Use Disorder: A Randomized Pilot Feasibility Study.

TypeinterventionalSponsorDenver Health and Hospital AuthorityRan2021 to 2022Enrolled44ConditionsAlcohol Use Disorder, SevereArmsNaltrexone 380 MG, Ketamine Hydrochloride, Enhanced linkage
3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 21 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
  5. Review
  6. Article
  7. Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Dale TerasakiDepartment of Behavioral Health, Denver Health & Hospital Association, 777 Bannock St, Denver, CO, 80204, USA. dale.terasaki@dhha.org.ORCID 0000-0001-8164-1608
Ryan LohDepartment of Behavioral Health, Denver Health & Hospital Association, 777 Bannock St, Denver, CO, 80204, USA.
Anastasia CornellRocky Mountain Poison and Drug Safety, Denver, CO, USA.
Julie TaubDepartment of Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
Christian ThurstoneDepartment of Behavioral Health, Denver Health & Hospital Association, 777 Bannock St, Denver, CO, 80204, USA.
Denver Health Medical Center · USWashington Poison Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlcohol use disorder (AUD) accounts for millions of acute care encounters annually in the United States. Hospitalization represents a vital opportunity to intervene pharmacologically, but low medication adherence is a significant barrier. Two single-dose, adherence-independent interventions are well suited for pre-discharge administration: intravenous (IV) ketamine and intramuscular (IM) naltrexone. Their feasibility and readmission-reducing efficacy in hospital settings are not well-established.

methodsA 3-arm, open-label randomized trial was conducted at our safety-net medical hospital among high-utilization inpatients with severe AUD. Consented adults (age 18-65) were randomized to (1) IV ketamine (KET) 0.5 mg/kg over 40 min, (2) IM naltrexone (NTX) 380 mg once, or (3) linkage alone (LA). The primary clinical outcome was 30-day all-cause hospital readmission rate. All were provided enhanced linkage to outpatient addiction clinic.

resultsWe consented and randomized 44 participants (n = 13, 14, 17 for KET, NTX, LA, respectively), with a mean of 3.2 past-year hospitalizations. Compared to the LA arm, both the KET arm (RR 0.37, p = 0.17) and NTX arm (RR 0.52, p = 0.27) had a lower 30-day readmission rate, though the differences were nonsignificant. Immediate acceptability ratings of KET and NTX were 9.50 and 9.17 out of 10, respectively. No serious adverse events or illicit ketamine use was reported.

conclusionsBoth interventions are feasible and showed promise in reducing readmissions for high-utilization AUD inpatients. Despite randomization, baseline characteristics may have differed in ways that biased against the control arm. Additional pragmatic studies-with larger sample size, blinding, and robust follow-up data collection-are needed to verify findings and better understand mediating factors. CLINICALTRIALS: gov Identifier NCT04562779. Registered 24 September 2020. https://clinicaltrials.gov/ct2/show/NCT04562779.

Indexed as

AlcoholismKetamineAdolescentAdultAgedFeasibility StudiesHumansInpatientsMiddle AgedNaltrexonePatient ReadmissionPilot ProjectsYoung AdultKetamineNaltrexoneAlcohol use disorderHospital utilizationKetamineMedication adherenceNaltrexone

Identifiers

PMID36419181
PMCPMC9682826
OpenAlexW4309700573

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.