The role and uptake of drug and alcohol services in patients with alcohol-associated acute pancreatitis at a large multisite health service.

BACKGROUND

Alcohol consumption remains an independent risk factor for recurrent presentations of alcohol-associated acute pancreatitis (AAP). Although there are recognised guidelines for alcohol use disorder (AUD), there are no recommendations on targeting alcohol cessation to reduce recurrence of AAP in guidelines for acute pancreatitis.

AIMS: This study describes the uptake of the Addiction Medicine Unit (AMU), a specialist consultative service, in patients with AAP presenting to a tertiary hospital.

METHODS

Retrospective cohort with all inpatients with AAP at a large multisite tertiary health service in Melbourne, Australia from May 2022 to May 2024. Demographics, AUD diagnosis and recommended interventions from the AMU were obtained from medical records.

RESULTS

There were 231 patients across 314 admissions with AAP identified with a high prevalence of AUD (91.8%). Referral to AMU occurred in 56.7% of admissions, predominantly among those with AUD (93.8%), with a tendency to refer patients with higher weekly alcohol intake (P = 0.024). The AMU recommended outpatient counselling services to assist with detoxification and rehabilitation in 40.4%, both pharmacological and outpatient interventions in 37.6% and medications alone in 21.9% of admissions. Over the 2-year period, 54 (23.4%) patients were readmitted with AAP. The adjusted analysis did not demonstrate reduced readmission with AAP associated with AMU review.

CONCLUSIONS

There is a substantial missed opportunity for specialist addiction medicine input in this cohort. AAP should be considered a sentinel alcohol-related hospital presentation, and the observed referral gap identifies an opportunity for more systematic addiction medicine assessment, pharmacotherapy initiation and linkage to longitudinal care.