Pharmacotherapy for alcohol use disorder among adults with medical disorders in Sweden.

Autor: Månsson A; Department of Global Public Health, Karolinska Institutet, Stockholm, 171 77, Sweden. anastasia.mansson@ki.se., Danielsson AK; Department of Global Public Health, Karolinska Institutet, Stockholm, 171 77, Sweden., Sjöqvist H; Department of Global Public Health, Karolinska Institutet, Stockholm, 171 77, Sweden., Glatz T; Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Public Health, Charitéplatz 1, Berlin, 10117, Germany., Lundin A; Department of Global Public Health, Karolinska Institutet, Stockholm, 171 77, Sweden.; Centre for Epidemiology and Community Medicine, Stockholm Region, Stockholm, 171 77, Sweden., Wallhed Finn S; Department of Global Public Health, Karolinska Institutet, Stockholm, 171 77, Sweden.; Mottagningen för alkohol och hälsa, Stockholm Center for Dependency Disorders, Health Care Services, Riddargatan 1, 114 35, Stockholm, Sweden.; Unit of Clinical Alcohol Research (UCAR), University of Southern Denmark, J.B. Winsløws Vej 20, entrance. 220 B, Odense, 5000, Denmark.
Jazyk: angličtina
Zdroj: Addiction science & clinical practice [Addict Sci Clin Pract] 2024 May 19; Vol. 19 (1), pp. 41. Date of Electronic Publication: 2024 May 19.
DOI: 10.1186/s13722-024-00471-9
Abstrakt: Background: Alcohol-attributable medical disorders are prevalent among individuals with alcohol use disorder (AUD). However, there is a lack of research on prescriptions of pharmacological treatment for AUD in those with comorbid conditions. This study aims to investigate the utilization of pharmacological treatment (acamprosate, disulfiram and naltrexone) in specialist care among patients with AUD and comorbid medical diagnoses.
Methods: This was a descriptive register-based Swedish national cohort study including 132,728 adults diagnosed with AUD (N = 270,933) between 2007 and 2015. The exposure was alcohol-attributable categories of comorbid medical diagnoses. Odds ratios (OR) were calculated using mixed-effect logistic regression analyses for any filled prescription of acamprosate, disulfiram or oral naltrexone within 12 months post AUD diagnosis.
Results: Individuals with comorbid alcohol-attributable medical diagnoses had lower odds of filling prescriptions for any type of AUD pharmacotherapy compared to those without such comorbidities. Cardiovascular (OR = 0.41 [95% CI: 0.39-0.43]), neurological (OR = 0.52 [95% CI: 0.48-0.56]) and gastrointestinal (OR = 0.57 [95% CI: 0.54-0.60]) diseases were associated with the lowest rates of prescription receipt. The presence of diagnoses which are contraindications to AUD pharmacotherapy did not fully explain the low prescription rate.
Conclusion: There is a substantial underutilization of AUD pharmacotherapy in patients with AUD and comorbid medical disorders in specialist care. Increasing the provision of pharmacotherapy to this group of patients is essential and may prevent morbidity and mortality. There is a need to further understand barriers to medical treatment both from the patient and prescriber perspective.
(© 2024. The Author(s).)
Databáze: MEDLINE
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