Matt Ronan

Hospitalist. Patient Safety and Quality. SUD interest. VA Boston. My tweets are my own.

[Journal of Hospital Medicine @JHospMedicine]

🍷❄️ Recovery doesn’t hibernate! Medications and follow-up in alcohol-use disorder reduces readmissions & boosts outcomes.

🔗: https://t.co/nMyFAt3H1l
✍️: @gunderson_craig @AnandJag1 @JoelBoggan @jeydithMd @mvronan @anneghena @jaclynvargasMD
🖼️: #VisualAbstract by @jenreadlynn

[Alcohol Journal @JournalAlcohol]

Our May issue of #Alcohol is now live. https://t.co/UXjfOh9mEV @neuRo_land @superkash @mvronan

[Rahul Ganatra @rbganatra]

Phenobarbital is effective for alcohol withdrawal.

But is it safe?

YES!

At VA Boston, we found that SAEs happened in 1 of 244 hospitalizations (0.4%).

There were ZERO:
- intubations
- ICU transfers for over-sedation
- deaths

https://t.co/PsjwdvOGzK

Kudos to @mvronan!

[Matt Ronan @mvronan]

@JoelBoggan @JAM_ASAM @VeteransHealth @gunderson_craig So many great questions left to ask and answer on the topic of alcohol withdrawal management. This look at management in light of the ASAM guideline recommendations gives some insights.

Still a lot of work to do in the field.

[Joel Boggan @JoelBoggan]

Out in @JAM_ASAM-our look across 19 @VeteransHealth🏥for mgt/outcomes for #alcohol #withdrawal led by @mvronan @gunderson_craig
🔹51% symptom-triggered💊alone (⬇️Rx duration)
🔹87%➡️some lorazepam (⬆️duration/complicated w/d)
🔹Delirium = 12.9%, Sz = 4.6%
https://t.co/krYdFzzOkz

[Michael Curry @michaelpcurry]

Michelle Lai et al 2007

[Journal of Hospital Medicine @JHospMedicine]

Happy Saturday! Is your patient stuck waiting for discharge? They are not alone.

Bann et al: at given time, ~10% pts on gen med services medically stable for DC >1 week (1/2 that: >1 month!)!

⬆️ common @ safety-net 🏥. ~85% pts need DC support.

#VisualAbstract by @CatieGlatz

[Journal of Hospital Medicine @JHospMedicine]

🕛 Shifting best practice towards 🥪 feeding and 🥤 hydrating before procedures, rather than prolonged fasting #hospitalmed #ptsafety

https://t.co/R1MbewPVTS

@ErinHommelMD

#VisualAbstract by @SuchitaSata

[Westyn Branch-Elliman, M.D., MMSc., FSHEA @wbranchelliman]

One of the most important lessons my mentor Kal Gupta taught me was to “keep it simple—“ we used that mantra to develop a feasible & scalable metric for state-wide, real-time pandemic monitoring

With @ShiraDoronMD, our experience in @AnnalsofIM @VA_CHOIR @VABostonHC @VAResearch

[Rahul Ganatra @rbganatra]

What an immense privilege it was to deliver the annual Update in Hospital Medicine with @hnyesf, and to record the recap with @thecurbsiders @monsta23 @MeredithTrubitt !

Thanks @SocietyHospMed for hosting us at #SHMConverge2023!

[Journal of Hospital Medicine @JHospMedicine]

😲 Is it really true that 40% of 🏥hospitalized patients with cellulitis are misdiagnosed?

👀 this https://t.co/wuhk6QelDL

[Jessica Taylor, MD @JessicaTaylorMD]

Same and next-day appointments available for buprenorphine, opioid withdrawal treatment, overdose prevention/naloxone, harm reduction counseling and equipment, HIV testing (rapid and phlebotomy-based) and #PrEP, linkage to long term care and more.

[Jessica Taylor, MD @JessicaTaylorMD]

As fall kicks off want to share contact for Faster Paths, the low-barrier #SUD bridge clinic @GraykenBMC with #Boston #MedTwitter. Faster Paths is open 7 days, 8-4. Call 617-414-4580 or walk in (1 Boston Medical Center Pl, Yawkey 1st Fl) for addiction treatment and #harmreduction

[Journal of Hospital Medicine @JHospMedicine]

📝 This systematic review summarizes national and international guidelines for management of opioid withdrawal & opioid use disorder, incorporating harm reduction, pain management, and use of non-stigmatizing language for people who use opioids.

⏩ https://t.co/xYnaU80Gjt

[Matt Ronan @mvronan]

@LaurenMerzMD Shorter turnaround, but I read it at the beginning or intern year and at the end of residency and had some similar reactions. Amazing as much as a lot has changed there are still some very deep rooted issues that invoke the same feelings so many years after publication.

[Westyn Branch-Elliman, M.D., MMSc., FSHEA @wbranchelliman]

In a next step, our team worked to identify risk factors for severe breakthrough infection (which was defined using hospitalization severity metrics)-- summary of these findings is posted here (5/n): https://t.co/d9QdBovSRz @julie_t_wu @JudithStrymish @mvronan

[Matt Ronan @mvronan]

@rbganatra If the disparity persists, a deeper understanding of why is needed. Then, we can improve our collective practice.

[Matt Ronan @mvronan]

@rbganatra The low rate of pharmacotherapy is unnerving. The health disparity that exists is unacceptable. The data, however, are old (FY2012). It would be enlightening to see if these trends persist with current data. If so the results would be that much more alarming.

[Matt Ronan @mvronan]

@JudithStrymish @tony_breu @BranchWestyn @GaitanisMelissa Things have improved a lot the last few years, but feels like we’re still fighting blind in many ways. Not knowing the variant is one of those ways given the implications on therapeutics.

[Matt Ronan @mvronan]

@ebtapper This would have come in handy about 6 months ago!