Discharge is where alcohol use disorder care is lost, and a five-item function score predicts where patients go next

The edition in brief

A systematic review of 17 studies (21 interventions) found that only 8 interventions improved linkage to outpatient care after a hospital admission for alcohol use disorder; those that worked generally combined behavioural support and care coordination with medication or social support, and certainty was low. An updated systematic review of 38 trials (25,816 adults without diabetes) gave placebo-subtracted weight loss of up to 5.8% for liraglutide, 14.8% for subcutaneous semaglutide, 14.3% for oral semaglutide, 12.4% for orforglipron and 19.0% for tirzepatide; gastrointestinal effects affected 76% versus 40% on placebo, and 10.7% versus 3.4% stopped for adverse events. Across 493,035 admissions in 21 hospitals, models using the five-item PROMIS physical function score predicted discharge to a skilled nursing facility with an AUC of 0.89 on day 3, against 0.75 for clinicians' expected disposition. Two online randomised trials in 6,272 US adults found that telling people about uncertainties behind a new cancer drug's approval cut hypothetical uptake by about 10 percentage points. A modelling study found non-targeted hepatitis C screening in emergency departments cost-effective at about $12,820 per QALY. The pearl is on starting alcohol use disorder medication before discharge.