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Decisional needs of intensive care unit survivors with alcohol use disorder considering alcohol treatment: A
Kelsey Hills-Dunlap1, Christopher E Knoepke2, Daniel D Matlock3
1Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, 12700 East 19th Avenue, 9C03, Aurora, CO, 80045, United States.
Introduction:
Alcohol use disorder (AUD) is a common and serious medical condition with substantial global public health impact, and it is prevalent among patients admitted to intensive care units (ICUs) in the United States. Many ICU survivors with AUD report motivation to change their drinking, however, few receive alcohol treatment. We sought to understand the decision support needs of ICU survivors with AUD when faced with choices about alcohol treatment options.
Methods:
In this qualitative study, we completed 17 semi-structured interviews with hospitalized patients with AUD recruited from two urban hospitals in the United States after an alcohol-related ICU admission. We used a reflexive thematic analysis and a deductive and inductive coding approach, with a-priori codes developed from the Ottawa Decision Support Framework.
Results:
Participants described any prior experience with alcohol treatment decisions and their current decision-making process regarding engagement with alcohol treatment after ICU admission. In our analysis, we developed four themes and associated subthemes: (1) Decisional needs included knowledge of alcohol's impact on health issues, awareness of treatment options, and trust in the recovery process; (2) Priorities regarding treatment options centered on cost, lifestyle integration, and personal experiences with addiction among treatment program staff; (3) Values regarding the decision making process included a sense of autonomy, relatedness to information providers, and productive involvement of social supports; (4) Decision aids should incorporate video formats to deliver transparent information regarding alcohol treatment options.
Conclusions:
Decisional needs of ICU survivors with AUD who are considering alcohol treatment reflect the importance of patient-centered information and consideration of patient preferences and values in alcohol treatment decisions. These findings will inform the development of an alcohol treatment decision aid to address these decisional needs and facilitate engagement with alcohol treatment for ICU survivors with AUD.
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