Sex and age differences in the early identification and treatment of alcohol use: a population‐based study of patients with alcoholic cirrhosis

Otete, Harmony; Orton, Elizabeth; West, Joe; Fleming, Kate M

doi:10.1111/add.13081

Cited by 15 publications

(12 citation statements)

References 37 publications

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“…Poor recording of alcohol use has two major impacts: first and most importantly, patients may not be receiving appropriate interventions; and second, for researchers, poor recording may prohibit reliable studies of the impact of alcohol on health using these data. Indeed, some recent studies using alcohol data in a large UK-based primary care electronic health record database (Clinical Practice Research Datalink (CPRD)) have indicated that bias may have arisen due to poor recording of alcohol data 8 9. For researchers using the data it is important to know not just whether screening occurs but if there are particular subgroups more likely to be screened and to what extent alcohol codes used are meaningful reflections of actual alcohol use.…”

Section: Introductionmentioning

confidence: 99%

Completeness and validity of alcohol recording in general practice within the UK: a cross-sectional study

et al. 2019

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BackgroundSince 2010 the National Institute for Health and Care Excellence has recommended screening adults for excessive alcohol consumption to try and help prevent alcohol-use disorders. Little is known about the extent to which these recommendations are followed, and the resulting completeness and validity of alcohol-related data recording in primary care.ObjectiveTo investigate the completeness and accuracy of recording of alcohol use within primary care records in the UK.Design and settingCross-sectional study in the Clinical Practice Research Datalink.ParticipantsWe included all adult patients registered on 1st January 2018 with ≥1 year of follow-up.Primary and secondary outcome measuresWe calculated prevalence of alcohol consumption recording overall and within patient groups. We then validated alcohol consumption data against recommended screening tools (Alcohol Use Disorders Identification Test (AUDIT)) as the gold standard. We also calculated how prevalence of alcohol recording changed over the preceding decade.ResultsIn 2018, among 1.8 million registered adult patients, just over half (51.9%) had a record for a code related to alcohol in the previous 5 years. Recording of alcohol consumption was more common among women, older people, ex-smokers and those from more deprived areas, who were overweight/obese, or with comorbidities. A quarter of patients had units per week recorded in the last 5 years, but <10% had an AUDIT or Fast Alcohol Screening Test (FAST) alcohol screening test score. The recorded alcohol measures corresponded to results from gold standard AUDIT scores. The distribution of consumption among current drinkers was similar to the Health Survey for England.ConclusionsHalf of adults in UK primary care have no recorded alcohol consumption data. When consumption is recorded, we have demonstrated internal and external validity of the data, suggesting greater recording may help identify opportunities for interventions to reduce harms.

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Section: Introductionmentioning

confidence: 99%

Completeness and validity of alcohol recording in general practice within the UK: a cross-sectional study

et al. 2019

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“…Studies examining sex differences in internalizing psychopathology in individuals with AUDs may have important implications for treatment. For instance, studies have shown that males tend to be more evasive to seeking treatment and respond less favorably to treatment when compared to females (Jarvis, 1992;John, Alwyn, Hodgson, & Phillips, 2008;Otete, Orton, West, & Fleming, 2015). It is possible that, if males are drinking to relieve symptoms of anxiety, elevated levels of trait anxiety may play a unique role in influencing male's decreased likelihood to seek and respond favorably to treatment.…”

Section: Discussionmentioning

confidence: 99%

Sex differences in trait anxiety’s association with alcohol problems in emerging adults: The influence of symptoms of depression and borderline personality

Atkinson

Finn

2019

Journal of Substance Use

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Objective: The co-occurrence of alcohol use disorder (AUD) and internalizing psychopathology, such as anxiety and depression, has been well documented. However, most studies of the association between alcohol problems and anxiety, and do not simultaneously consider depression or borderline personality, which covary strongly with both anxiety symptoms and AUDs. The current study examined sex differences in the association between alcohol problems and anxiety, while accounting for depressive and borderline personality (BPD) symptoms. Method: A sample 810 (364 females) young adults aged 18-30 recruited from the community, who varied widely in lifetime alcohol problems, were administered diagnostic interviews and measures of a trait anxiety, depression, and BPD symptoms. Results: Analyses revealed that trait anxiety, depression, and borderline symptoms were all significantly associated with higher lifetime alcohol problems in both males and females. However, the association between trait anxiety and alcohol problems was significantly stronger for males compared with females, even when controlling for depression and BPD symptoms. There were no significant sex differences in the association between alcohol problems and symptoms of either depression or BPD symptoms. Conclusion: This suggests specific sex differences in the mechanisms by which trait anxiety is associated with alcohol problems.

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“…Future studies should assess contacts with obvious alcohol problems in primary care in addition to hospital contacts to compare where patients are most frequently seen with alcohol problems prior to diagnosis of alcoholic liver cirrhosis or alcoholic pancreatitis[ 18 , 20 , 42 ].…”

Section: Discussionmentioning

confidence: 99%

Hospital contacts with alcohol problems prior to liver cirrhosis or pancreatitis diagnosis

Askgaard¹,

Neermark²,

Leon³

et al. 2017

WJH

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AIMTo evaluate prior hospital contacts with alcohol problems in patients with alcoholic liver cirrhosis and pancreatitis.METHODSThis was a register-based study of all patients diagnosed with alcoholic liver cirrhosis or pancreatitis during 2008-2012 in Denmark. Hospital contacts with alcohol problems (intoxication, harmful use, or dependence) in the 10-year period preceding the diagnosis of alcoholic liver cirrhosis and pancreatitis were identified.RESULTSIn the 10 years prior to diagnosis, 40% of the 7719 alcoholic liver cirrhosis patients and 40% of the 1811 alcoholic pancreatitis patients had at least one prior hospital contact with alcohol problems. Every sixth patient (15%-16%) had more than five contacts. A similar pattern of prior hospital contacts was observed for alcoholic liver cirrhosis and pancreatitis. Around 30% were diagnosed with alcohol dependence and 10% with less severe alcohol diagnoses. For the majority, admission to somatic wards was the most common type of hospital care with alcohol problems. Most had their first contact with alcohol problems more than five years prior to diagnosis.CONCLUSIONThere may be opportunities to reach some of the patients who later develop alcoholic liver cirrhosis or pancreatitis with preventive interventions in the hospital setting.

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Sex and age differences in the early identification and treatment of alcohol use: a population‐based study of patients with alcoholic cirrhosis

Cited by 15 publications

References 37 publications

Completeness and validity of alcohol recording in general practice within the UK: a cross-sectional study

Completeness and validity of alcohol recording in general practice within the UK: a cross-sectional study

Sex differences in trait anxiety’s association with alcohol problems in emerging adults: The influence of symptoms of depression and borderline personality

Hospital contacts with alcohol problems prior to liver cirrhosis or pancreatitis diagnosis

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