Models of care for the management of alcohol use disorder in general hospital settings and transition to the community: a scoping review.

BACKGROUND

Early detection of alcohol use disorder (AUD) amongst people admitted to general hospitals offers an opportunity for early intervention and accesses to evidence-based care. However, current operational models for the management of AUD in these settings are poorly defined, limiting the ability to assess their impact on individual patient outcomes, treatment effectiveness, or healthcare system efficiency. This scoping review aims to identify and characterize existing models of AUD management within general hospitals.

METHODS

A scoping review approach was adopted, including relevant peer-reviewed publications between 1990 and 2025. Studies needed to report on ≥2 care components (systematic screening, brief interventions, medically assisted alcohol withdrawal, relapse prevention initiation, psychosocial interventions, transition to community, provision of training) to be included. Screening and data extraction were performed independently by at least reviewers.

RESULTS

Fifty-one (n = 51) records were included, and four distinct models of care were identified (consultation liaison; screening, brief intervention, and referral to treatment; protocol implementation; supported diversion). Models varied in their clinical purpose, target population, and care delivery focus. Within each model, differences in aims, context, and implementation resulted in substantial heterogeneity.

CONCLUSION

Consultation liaison models provided the most multifaceted care, with a specialist team providing clinical leadership, access to evidence-based interventions, transition to community services, and training of the wider workforce, but rarely described any wider systematic screening for AUD. A consistent observation across all identified models was the limited interface with mental health care, representing a critical gap in current AUD management within general hospitals.