# Improving the Safety of Treatment for Hospitalized Patients with Alcohol Withdrawal Syndrome

> **NIH NIH K23** · UNIVERSITY OF WASHINGTON · 2022 · $188,028

## Abstract

PROJECT SUMMARY/ABSTRACT
BACKGROUND. The goal of this proposal is to improve outcomes for hospitalized patients with Alcohol
Withdrawal Syndrome (AWS). AWS is common in hospitals and can be fatal without appropriate management;
however, treatments for AWS also have dangerous side effects. Suboptimal treatment (persistent agitation or
oversedation) leads to adverse events (e.g., use of physical restraints or mechanical ventilation), which are
potentially avoidable but have never been studied. Moreover, the two types of medications used as first-line
therapy for inpatient AWS—benzodiazepines and phenobarbital—have never been rigorously compared in
hospitalized patients. Both treatments are recommended by guidelines at the discretion of clinicians, yet their
comparative safety remains unknown. CANDIDATE. Dr. Tessa Steel is a critical care physician who co-led a
national panel of experts to develop a comprehensive research agenda for improving the care of severe AWS.
The proposed K23 builds on this foundation and her prior studies, showing wide variation in current treatments
for inpatient AWS. RESEARCH. First, Dr. Steel will investigate how and why inpatient physicians choose to
treat inpatient AWS with benzodiazepines versus phenobarbital, using interviews and an implementation
science framework for understanding provider behavior. Second, she will evaluate the risk of adverse events
(e.g., use of physical restraints) associated with benzodiazepines versus phenobarbital in diverse groups of
hospitalized patients, using real-world data from electronic health records (EHRs). These studies will inform
her third aim—to design and pilot a pragmatic randomized trial, embedded in hospital care, comparing
benzodiazepines to phenobarbital for hospitalized patients with AWS. The pilot will serve as groundwork for a
definitive multi-center randomized trial (Dr. Steel’s planned R01) to determine the safest first-line therapy for
inpatient AWS. CAREER DEVELOPMENT. Dr. Steel’s goal is to be an innovative clinical researcher who
improves outcomes for hospitalized patients with alcohol use disorder. To launch her career as an
independent physician scientist, the proposed K23 award provides essential training in (1) qualitative research
methods, (2) advanced analytic strategies for using EHR data, and (3) the design and conduct of embedded
pragmatic clinical trials. Dr. Steel will conduct her research at the University of Washington (UW) under the
primary mentorship of Dr. Katharine Bradley, who is an expert in mixed methods research using EHR data,
including pragmatic trials. She will be co-mentored by Dr. Nicholas Johnson, providing expertise related to
clinical trials conducted in hospital settings and Dr. Kevin Hallgren, a methodologic expert on the use of EHR
data for clinical AUD research. PUBLIC HEALTH IMPACT. The proposed career development award will
support an early-career investigator conducting research to improve management of AWS for the ~2 million
pa...

## Key facts

- **NIH application ID:** 10570535
- **Project number:** 1K23AA030588-01
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Tessa Lynne Steel
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $188,028
- **Award type:** 1
- **Project period:** 2022-09-20 → 2027-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10570535

## Citation

> US National Institutes of Health, RePORTER application 10570535, Improving the Safety of Treatment for Hospitalized Patients with Alcohol Withdrawal Syndrome (1K23AA030588-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10570535. Licensed CC0.

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