INDIVIDUALIZED TREATMENT FOR ALCOHOL WITHDRAWAL. J. Daeppen 1 , P. Gache 1 , U. Landry 1 , E. Sekera 1 , V. Schweizer 1 , S. Gloor 1 , B. Yersin 1 ; 1 Alcohol Treatment Center, Lausanne PURPOSE: To assess the effect of an individualized treatment regimen on the quantity and duration of benzodiazepine prescribed for alcohol withdrawal. METHODS: A randomized double-blind controlled trial including 117 consecutive patients admitted in an alcohol treatment program was conducted. Patients were randomized into two groups: i) 56 patients were treated with oxazepam only in response to the development of signs of alcohol withdrawal (symptom-triggered), and ii) 61 were treated with oxazepam every 6 hours with additional doses as needed (fixed-schedule). The administration of additional oxazepam was determined using the CIWA-Ar, a validated measure of the severity of alcohol withdrawal. RESULTS: 40% of the patients in the symptom-triggered group were treated with oxazepam, compared to 100% in the fixed-schedule group (p < .001). Mean oxazepam administered in the symptom-triggered group was 40 mg compared to 230 mg in the fixed-schedule group (p < .001). Mean duration of oxazepam treatment was 20 hours in the symptom-triggered group compared to 63 hours in the fixed-schedule group (p < .001). There were no differences in the incidence of complications and in the measures of comfort between the two groups. CONCLUSION: A symptom-triggered pharmacological treatment decreases the quantity and duration of benzodiazepine prescribed in alcohol withdrawal, with similar safety and comfort. Since both HIV/AIDS and its treatments commonly cause adverse somatic effects, symptom assessment is necessary for delivering and evaluating care for people with HIV. This study compared three methods to assess patient reported symptoms (presence, frequency, and bother) and to validate report of individual symptoms using longer patient-reported scales and clinical parameters in people with HIV disease. METHODS: Prospective cohort study. A questionnaire completed by 160 individuals on two occasions, four months apart. The questionnaire included 39 HIV-related symptoms, the Medical Outcomes Study-HIV Health Survey (MOS-HIV), and Health Transition items. Correlation coefficients were calculated to assess relationships between summary scores for the three symptom methods with health-related quality of life domains, CD4 counts, and HIV disease stage. Analyses were stratified by HIV disease stage to determine if correlations differed with respect to clinical stage. RESULTS: Sixty-seven percent of subjects were male, 63.5% were African-American, and 26% had less than a high school education. The percentage of participants with AIDS, symptomatic HIV, and asymptomatic HIV were 46.2%, 28.5%, and 25.3%, respectively with mean CD4 counts of 194, 386, and 400, respectively. The average number of symptoms reported was 15.2 (SD=8.4). There were statistically significant correlations between CD4 count and symptom frequency, symptom bother, and symptom presence. As hypothesized, correlations with the MOS-HIV Quality of Life domain were moderate and statistically significant whereas there were no significant correlations with the Quality of Life Transition score. Examination of individual symptoms revealed that fatigue and decreased memory were significantly correlated with both the Health Transition and MOS-HIV scores. Presence, frequency, and bother scores for trouble falling asleep were correlated with Sleep scale scores. Presence and frequency of fever correlated significantly with CD4 count. Bodily pain had statistically significant correlations with the Pain domain of the MOS-HIV. Hot/cold spells were not significantly correlated with CD4 count. CONCLUSION: The three symptom methods and their scores were strongly intercorrelated. Participants with more symptoms reported greater frequency and bother from symptoms.