Modeling Long-Term Effectiveness of Prevention of Harmful and Hazardous Alcohol Consumption Based on Screening and Brief Intervention

Abstract

© Коллектив авторов, 2014 г.Данные обследования 3442 человек были использованы для построения когортно-марковской модели оценки эффективности профилактики опасного и вредного потребления алкоголя на основе скрининга и краткосрочного вмешательства (СКСВ). Установлено, что в рамках пессимистичного сценария внедрение СКСВ в Российской Федерации будет ассоциировано с предотвращением ежегодных потерь в 18 716 лет, откорректированных на качество жизни (95% ДИ = 17 611-19 819), в случае более оптимистичного сце-нария эффективности СКСВ число предотвращенных потерь увеличивается до 564 618 лет (95% ДИ = 539 910-589 327). Данный эффект означает, что вмешательство будет давать на каждый вложенный во вме-шательство рубль от 5,92 рублей (95% ДИ = 5,57-6,27 рублей) до 179 рублей (95% ДИ = 171-186 руб-лей). Сравнение с другими профилактическими вмешательствами показывает, что СКСВ относится к группе стоимостно-эффективных вне зависимости от того, используется пессимистический или оптими-стичный сценарий эффекта.Ключевые слова: опасное и вредное потребление алкоголя, алкоголь-ассоциированные заболева -ния, стоимость-эффективность, DALY (количество потерянных лет жизни, откорректированных на инва-лидность).Based on the results of the screening of the 3442 persons Marcov-cohort model was used to estimate results of the preventive program based on the methodology of screening and brief intervention (SBI) to prevent harmful and hazardous alcohol consumption. It is found, that in case of pessimistic scenario introduction of SBI in Russian Federation will be associated with avoidance of 18 716 disability-adjusted life-years (DALY) (95% CI = 17 611-19 819), in case of more optimistic scenario effectiveness of SBI increase to 564 618 DALY (95% CI = 539 910-589 327). This means that economical effect will be from 5,92 rubles per each ruble invested in the SBI (95% CI = 5,57-6,27 rubles) to 179 rubles (95% CI = 171-186 rubles). Comparison to other preventive pro grams show, that SBI is a cost-effective intervention independent of the pessimistic or optimistic scenario used.

Translating and adapting the Alcohol Use Disorders Identification Test (AUDIT) for use in the Russian Federation: A multicentre pilot study to inform validation procedures

“…For instance, previous studies using the full 10-item version of the AUDIT found that 76% of male and 47% of female dermatology patients and 55% of male and 45% of female general practice patients exceeded the non-sex-specific cut-off score of ≥8 for hazardous drinking, although these studies have been using slightly different translations and modifications of the tool (Plavinski et al, 2012a). The same research group found even higher proportions in male patients of dermatologists (57%) and general practitioners (80%) when using the same AUDIT version and the same cut-off score of ≥8 (Barinova et al, 2013b). The same study found that every 10th patient who presented to a general practitioner potentially had an AUD because they had an AUDIT score of ≥20.…”

“…Another study comparing AUDIT and CAGE outcomes with drinking diaries in a sample of men from detention facilities (n = 100, aged 19-47 years) and age-matched controls (n = 100) who were patients of general practitioners (n = 50) and patients of dermatovenerologists (n = 191) suggested a high alcohol intake in the prisoners group before detention as measured through drinking diaries (average alcohol intake of about 450 g of ethanol per week); however, this could not be adequately measured through the first three AUDIT items because the first item assesses current consumption status (Barinova et al, 2013b). Various other studies from the same research group have investigated the performance of the AUDIT in older adults and various patient groups as well as its correlation with biomarkers and skin symptoms that might predict higher alcohol intake (Barinova et al, 2013a;Plavinski et al, 2013b).…”

“…However, there is a series of studies, which have examined the performance of the AUDIT, i.e., various translated versions of the tool with undocumented translation procedures, in various patient samples, comparing its performance with the outcomes of drinking diaries and exploring correlations with different instruments, such as the Composite International Diagnostic Interview (CIDI), CAGE or Beck's Depression Inventory (Barinova et al, 2013b;Plavinski et al, 2012bPlavinski et al, , 2013aYanov et al, 2009). For instance, a study involving a relatively large sample (n = 1538), comprising subsamples of medical students (n = 529), patients of general practitioners (n = 411), patients of dermatovenerologists (n = 581) and patients seeking obstetric/gynaecological care (n = 17), compared the AUDIT scores with alcohol consumption diaries, revealing a weak correlation between the two (Plavinski et al, 2012b).…”