Interventions to Improve Outpatient Follow-up for Hospitalized Patients With Alcohol Use Disorder : A Systematic Review
In brief
Only about a third of tested programs boost outpatient follow-up after alcohol-related admission
In a systematic review of 17 studies (about 12,000 patients), 8 of 21 hospital-based interventions modestly increased post-discharge clinic attendance, with gains ranging up to a 30% absolute rise. Most effective approaches mixed counseling, care coordination, and medication or social support, but overall evidence is low certainty, underscoring the need for better trials.
- Journal
- Annals of internal medicine (Q1)
- Published
- 8 September 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Eden Y Bernstein, Kelsey Hills-Dunlap, Ariyani Challapalli, Lisa Bero, Susan L Calcaterra, E Jennifer Edelman, et al.
- PMID
- 42704903
- DOI
- 10.7326/ANNALS-26-01312
Why clinicians should know about it
- Picked for Internal Medicine (top studies of the week, 13 September 2026): High-quality evidence in a top journal
Abstract
BACKGROUND: Hospitalizations for alcohol use disorder (AUD) are common and morbid. Outpatient follow-up after discharge is critical for reducing alcohol use and subsequent readmissions, but effective interventions to support this transition are unknown. PURPOSE: To summarize evidence on the effectiveness of hospital-based interventions to improve outpatient follow-up for AUD. DATA SOURCES: Ovid MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, PsycInfo, and CINAHL (January 2000 to February 2025). STUDY SELECTION: Two authors independently reviewed abstracts and full-text articles to identify hospital-based trials and cohort studies that evaluated interventions to improve outpatient AUD follow-up versus usual care or an active comparator. DATA EXTRACTION: Study data were extracted by 2 authors using a standardized template. Risk of bias and certainty of evidence were assessed using the Cochrane Risk of Bias Tool, Newcastle-Ottawa Scale, and GRADE (Grading of Recommendations Assessment, Development and Evaluation). DATA SYNTHESIS: Seventeen studies of 21 interventions (12 randomized clinical trials [RCTs] [n = 1917], 3 nonrandomized trials [n = 459], and 2 cohort studies [n = 9974]) were included. Interventions were heterogeneous, and most (85%) included several components: behavioral (76%), care coordination (76%), medication management (14%), and social support (33%). Eight interventions (38%) reported improved linkage to outpatient follow-up. Effective interventions generally combined behavioral and care coordination with AUD medications or social support. Effect sizes across RCTs ranged from an 8% absolute decrease to a 30% absolute increase in outpatient follow-up. The certainty of evidence was low due to the high risk of bias and imprecision of results. LIMITATION: Only English-language publications were included. CONCLUSION: Few intervention studies of low certainty improved posthospitalization follow-up for patients with AUD. Given the substantial morbidity associated with untreated AUD, high-quality RCTs testing various components of interventions are needed. PRIMARY FUNDING SOURCE: None. (PROSPERO: CRD42025636943).
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.