A retrospective evaluation of phenobarbital versus benzodiazepine monotherapy for alcohol withdrawal syndrome in the emergency department (the PHENOBENZ-RETRO study)

Background: A single-site retrospective study conducted in North Battleford comparing benzodiazepine (BZD) and phenobarbital (PB) treatment in alcohol withdrawal syndrome (AWS) found that phenobarbital therapy performed better or equally as well as benzodiazepine therapy¹. These findings led to the release of a new order set containing both PB and BZD treatment arms. The current study constitutes a multi-site expansion of the previous study.

Outcomes: Primary outcomes include establishing the non-inferiority of PB with regards to safety and determining whether the use of PB results in shorter admission times and lower admission rates when compared to BZD use. Secondary outcomes are gauging the uptake of the new provincial order set and analyzing site differences.

Methods: A review of charts containing a primary or secondary emergency department diagnosis related to AUD or AWS with ED presentations, conducted between the order set launch and chart review date (October 2023 to present) across six sites in Saskatchewan.

Methods, Results and Conclusions: Data collection is ongoing and primary outcomes and secondary outcomes cannot be determined. Based on initial analysis, adoption of the new order set and the PB treatment arm varies widely across the province, with greatest use in North Battleford.