Background
Rationale
Research questions and objectives
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What is the 12-month prevalence of AD in primary health care (by region and across regions), and how do people with an AD diagnosis differ from those without?
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What is the proportion of people with AD in treatment or receiving other interventions for their alcohol problems?
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What characteristics of the patient are linked to treatment provision?
Methods
Regions
Setting and participant sampling
Variables and measurement
Statistical methods
AD diagnosis by GP | AD diagnosis by CIDIa | AD diagnosis by GP or CIDIa | |||||||
---|---|---|---|---|---|---|---|---|---|
Male | Female | Total | Male | Female | Total | Male | Female | Total | |
(N = 5,461) | (N = 7,542) | (N = 13,003) | (N = 3,715) | (N = 5,383) | (N = 9,098) | (N = 3,449) | (N = 5,027) | (N = 8,476) | |
Percentage diagnosed % (CI) | 8.7 (8.0 - 9.4) | 2.5c (2.2 - 2.9) | 5.1 (4.7 - 5.5) | 9.4 (8.4 - 10.3) | 3.0c (2.5 - 3.4) | 5.5 (5.1 - 6.0) | 14.6 (13.4 - 15.7) | 4.8c (4.2 - 5.3) | 8.7 (8.1 - 9.3) |
Sought and received professional helpb % (CI) | 28.6 (24.2 - 33.0) | 19.6d (13.5 - 25.8) | 26.0 (22.4 - 29.7) | 18.5 (14.5 - 22.5) | 14.8 (9.1 - 20.4) | 17.3 (14.0 - 20.6) | 24.1 (20.4 - 27.8) | 18.6 (13.7 - 23.5) | 22.3 (19.4 - 25.2) |
Ethical approval
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Germany: “Ethikkommission an der TU Dresden“ (Ethics committee at Dresden University of Technology)
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Hungary: “Budapesti Corvinus Egyetem Társadalomtudományi Kara Etikai Bizottság” (Corvinus University of Budapest, Faculty of Social Ethics Committee)
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Italy1 (Friuli-Venezia Giulia): “Comitato Etico Indipendente dell'Azienda per i Servizi Sanitari 2 ‘Isontina’ ” (Independent Ethics Committee of the Company for Health Services n°2 ‘Isontina’)
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Italy2 (Tuscany): “Comitato Etico dell'Azienda Sanitaria Firenze” (Ethical Board of Florence Health Agency)
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Latvia: “Ētikas komitejas Rīgas Austrumu klīniskās universitātes slimnīcas Atbalsta fonds“ (Ethics Committee of the Riga Eastern Clinical University Hospital Support Fund)
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Poland: “Komisja Bioetyczna przy Warszawskim Uniwersytecie Medycznym” (Bioethics Committee at the Medical University of Warsaw)
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Spain: ”Comité Ético de Investigación Clínica. Hospital Clínic de Barcelona” (Hospital Clinic of Barcelona. Ethics Committee for Clinical Research)
Results
Participants and descriptive data
Prevalence of alcohol dependence
Comparison of patients with and without alcohol dependence
No AD diagnosis (N = 7,656) | AD diagnosis by GP or CIDI (N = 820) | Odds ratioa(95 % confidence interval) | Regression coefficienta(95 % confidence interval) | |
---|---|---|---|---|
Age mean (SD) | 44.3 (13.1) | 45.1 (13.8) | 0.79 (−0.20 - 1.78) | |
SES – self classified % (CI) below average | 20.1 (19.2 - 21.0) | 33.7 (30.4 - 37.1) | 2.07 (1.76 - 2.44)b | |
Unemployed for health or other reason % (CI) | 11.8 (11.1 - 12.6) | 25.2 (22.2 - 28.2) | 2.63 (2.20 - 3.15)b | |
Smoking % (CI) | 29.5 (28.5 - 30.5) | 58.8 (55.4 - 62.3) | 3.16 (2.70 - 3.69)b | |
BMI mean (SD) | 26.3 (5.2) | 25.9 (5.5) | −0.73 (−1.12 - -0.34)b | |
Hypertension % (CI) | 25.7 (24.7 - 26.7) | 33.1 (29.8 - 36.4) | 1.30 (1.09 - 1.56) | |
Liver problems % (CI) | 1.9 (1.5 - 2.2) | 13.7 (11.3 - 16.1) | 7.45 (5.60 - 9.90)b | |
Depression % (CI) | 6.9 (6.4 - 7.5) | 14.2 (11.7 - 16.6) | 2.46 (1.95 - 3.09)b | |
Anxiety % (CI) | 9.1 (8.5 - 9.8) | 18.7 (15.9 - 21.4) | 2.62 (2.14 - 3.22)b | |
K10 | ||||
Above cut-off for serious mental distress % (CI) | 5.1 (4.6 - 5.6) | 12.1 (9.8 - 14.4) | 2.81 (2.19 - 3.60)b | |
Total score mean (SD) | 6.8 (7.0) | 10.5 (8.5) | 4.14 (3.55 - 4.74)b | |
WHODAS 2.0 | ||||
Number of days of inability to carry out usual activities or work due to health condition mean (SD) | 1.3 (4.6) | 2.6 (6.7) | 1.21 (0.74 - 1.68)b | |
Total score mean (SD) | 8.6 (12.6) | 13.7 (16.1) | 5.59 (4.47 - 6.70)b | |
Amount of ethanol used daily (in gram)c mean (SD) | 28.5 (24.7) | 57.6 (57.3) | 28.44 (23.23 - 33.65)b | |
Chronic heavy drinkingc % (CI) at least 100 g ethanol daily | 2.2 (1.4 - 3.0) | 15.8 (12.4 - 19.2) | 7.95 (5.10 - 12.40)b | |
Binge drinkingc % (CI) at least 200 g ethanol at least weekly | 3.4 (2.4 - 4.3) | 15.9 (12.5 - 19.3) | 5.34 (3.60 - 7.93)b |
Help seeking
Male patients with AD (N = 558) | Female patients with AD (N = 262) | |||
---|---|---|---|---|
No treatment received (N = 423) | Treatment received (N = 135) | No treatment received (N = 214) | Treatment received (N = 48) | |
Age mean (SD) | 44.5 (14.2) | 49.0 (11.5)a | 43.4 (14.7) | 47.1 (11.3) |
SES – self classified % (CI) below average | 33.2 (28.6 - 37.9) | 37.5 (28.9 - 46.1) | 30.6 (24.3 - 37.0) | 41.6 (27.1 - 56.1) |
Unemployed for health or other reason % (CI) | 23.5 (19.4 - 27.6) | 26.4 (18.8 - 34.1) | 26.4 (20.5 - 32.3) | 31.5 (18.0 - 44.9) |
Smoking % (CI) | 59.0 (54.2 - 63.8) | 69.1 (61.0 - 77.2) | 53.3 (46.5 - 60.1) | 54.4 (39.8 - 68.9) |
BMI mean (SD) | 26.3 (5.3) | 26.6 (6.0) | 24.8 (5.5) | 25.9 (6.0) |
Hypertension % (CI) | 31.2 (26.7 - 35.7) | 44.7 (36.0 - 53.4) | 28.0 (21.9 - 34.1) | 40.1 (25.6 - 54.7) |
Liver problems % (CI) | 10.9 (8.0 - 13.9) | 28.1 (20.1 - 36.1)a | 7.6 (3.9 - 11.3) | 25.7 (12.8 - 38.5) |
Depression % (CI) | 10.5 (7.5 - 13.5) | 20.6 (13.6 - 27.6) | 13.1 (8.3 - 17.9) | 32.5 (18.4 - 46.6) |
Anxiety % (CI) | 14.1 (10.8 - 17.4) | 28.0 (20.0 - 35.9)a | 18.3 (13.0 - 23.5) | 34.4 (20.2 - 48.6) |
K10 | ||||
Above cut-off for serious mental distress % (CI) | 8.2 (5.5 - 10.9) | 20.6 (13.5 - 27.7)a | 13.9 (9.1 - 18.6) | 14.2 (3.2 - 25.2) |
Total score mean (SD) | 8.9 (7.6) | 13.4 (9.3)a | 11.3 (8.9) | 12.7 (9.1) |
WHODAS 2.0 mean (SD) | ||||
Number of days of inability to carry out usual activities or work due to health condition | 2.3 (6.4) | 4.4 (9.0) | 2.2 (5.7) | 2.2 (6.4) |
Total score | 12.1 (15.4) | 18.5 (19.4)a | 13.0 (14.7) | 17.5 (17.5) |
Amount of ethanol used daily (in gram)b mean (SD) | 50.8 (46.2) | 90.3 (78.8)a | 43.3 (48.7) | 64.9 (63.4) |
Chronic heavy drinkingb % (CI) at least 100 g ethanol daily | 12.6 (8.5 - 16.7) | 29.9 (20.2 - 39.6)a | 9.3 (3.1 - 15.4) | 23.1 (5.2 - 41.1) |
Binge drinkingb % (CI) at least 200 g ethanol at least weekly | 15.6 (11.1 - 20.2) | 21.6 (12.8 - 30.4) | 10.2 (3.9 - 16.6) | 19.2 (2.3 - 3.6) |