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Alcoholism: Clinical and Experimental Research 2015:39(12);2455-2462

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Alcoholism: Clinical and Experimental Research 2015:39(12);2455-2462

69. Effectiveness of a Dutch community-based alcohol intervention: Changes in alcohol use of adolescents after 1 and 5 years

Sophia C. Jansen, Annemien Haveman-Nies, Inge Bos-Oude Groeniger, Cobi Izeboud, Carolien de Rover, Pieter van’t Veer

Drug and Alcohol Dependence 2016:159;125-132


1. A Systematic Review on the Effectiveness of Brief Interventions for Alcohol Misuse among Adults in Emergency Departments

Meredith S.H. Landy, Caitlin J. Davey, David Quintero, Amanda Pecora, Kelly E. McShane

Journal of Substance Abuse Treatment 2016:61;1-12

Given the frequency with which individuals seek treatment for alcohol-related consequences in emergency departments (EDs), they may be the optimal setting to deliver brief interventions (BIs) for alcohol misuse. Studies examining the effectiveness of BIs for alcohol misuse conducted in EDs have yielded mixed results, and new articles have been published since the last review in 2008. The aim of this study was to provide an updated systematic review on the effectiveness of BIs for alcohol misuse delivered to adults in EDs. Articles published in June 2014 and earlier were identified from online databases (PsycInfo, Healthstar, CINAHL, Medline, Nursing and Allied Health). Search terms included (1) alcohol, (2) “alcohol screening”, “brief intervention”, “brief alcohol intervention” or feedback and (3) “emergency department” or “emergency room”. Once duplicates were removed, 171 abstracts were identified for review. Thirty-four studies were included in the systematic review. All studies reported a significant reduction in alcohol consumption at 3 months post-BI, with some studies finding significant differences between the BI and control groups, and other studies finding significant decreases in both conditions but no between-groups differences. The majority of studies did not find significant between-group differences at 6 and 12 months post-BI with regard to decreases in alcohol consumption. Individuals who received a BI were significantly less likely to have an alcohol-related injury at 6 or 12 months post-BI than individuals who did not receive a BI. BIs are unlikely to reduce subsequent hospitalizations however, they may be effective in reducing risky driving and motor vehicle crashes associated with alcohol use, which can result in hospitalization. Beyond the effects generated by visiting EDs, BIs delivered in EDs may not be effective in reducing alcohol consumption, or in reducing subsequent hospitalizations. BIs may be effective in reducing some alcohol-related consequences. Future studies ought to investigate for whom BIs are most effective, and the processes that lead to decreases in alcohol consumption and alcohol-related consequences.

Keywords: Brief intervention; Alcohol; Emergency department; Adults; Systematic review


2. A lifetime history of alcohol use disorder increases risk for chronic medical conditions after stable remission

Tomoko Udo, Elizabeth Vásquez, Benjamin A. Shaw

Drug and Alcohol Dependence 2015:157;68-74

Background The long-term impact of a past alcohol use disorder (AUD) among those who are currently in stable remission has not been well-explored. This study examined whether a past history of AUD was associated with increased risk for chronic medical conditions in a large U.S. nationally representative sample of adults ≥30 years old.

Methods Using 25,840 participants from Wave 1 and Wave 2 surveys of the National Epidemiologic Survey on Alcohol and Related Condition (NESARC), multiple logistic regression analysis was conducted to compare the risk for reporting metabolic, cardiovascular, liver, gastrointestinal, and inflammatory conditions between those in full-remission from AUD for longer than 5 years and those without a history of AUD diagnosis. Results Compared with a model adjusting only for age, a model adjusting for other potential psychosocial confounders revealed fewer significant associations between AUD history and chronic medical conditions, particularly for the middle-aged population and for men. For the elderly, AUD history was associated with more chronic medical conditions in fully adjusted models. AUD history was associated with severe medical conditions such as liver diseases and myocardial infarction in women. In general, longer AUD exposure and shorter remission were also associated with the risk for chronic medical conditions. Conclusions Our findings suggest associations between past AUD diagnosis and chronic medical conditions, particularly for the elderly individuals. Screening for past alcohol use problems and associated health risks are important for the promotion of aging and prevention of chronic medical conditions even when an individual presents no current symptoms of AUD.

Keywords: Alcohol use disorder; Remission; Past diagnosis; Chronic medical conditions; Age; Gender

3. Alcohol Dependence, Co-occurring Conditions and Attributable Burden

B.L. Odlaug, A. Gual, J. DeCourcy, R. Perry, J. Pike, L. Heron, J. Rehm

Alcohol and Alcoholism 2016:51(2);201-209

Aims Alcohol dependence is associated with high rates of co-occurring disorders which impact health-related quality of life (HRQoL) and add to the cost-of-illness. This study investigated the burden of alcohol dependence and associated co-occurring conditions on health and productivity. Methods A cross-sectional survey was conducted in eight European countries. Physicians (Psychiatrists and General Practitioners) completed patient record forms, which included assessment of co-occurring conditions, and patients completed matching self-completion forms. Drinking risk level (DRL) was calculated and the relationship between DRL, co-occurring conditions, work productivity, hospitalisations and rehabilitation stays was explored. Results Data were collected for 2979 alcohol-dependent patients (mean age 48.8 ± 13.6 years; 70% male). In total, 77% of patients suffered from moderate-to-severe co-occurring psychiatric and/or somatic conditions. High DRL was significantly associated with depression, greater work productivity losses, increased hospitalisations and rehabilitation stays. Co-occurring conditions were significantly associated with poorer HRQoL and decreased work productivity, with a statistical trend towards an increased frequency of rehabilitation stays. Conclusions Alcohol-dependent patients manifest high rates of co-occurring psychiatric and somatic conditions, which are associated with impaired work productivity and HRQoL. The continued burden of illness observed in these already-diagnosed patients suggests an unmet need in both primary and secondary care.


4. Patterns of alcohol consumption and health-related quality of life in older adults

Rosario Ortolá, Esther García-Esquinas, Iñaki Galán, Fernando Rodríguez-Artalejo

Drug and Alcohol Dependence 2016:159;166-173


Background Health-related quality of life (HRQOL) is a more powerful predictor of health services use and mortality than many objective measures of health. However, in older adults the association between main alcohol drinking patterns and HRQOL is uncertain.

Methods A prospective cohort with 2163 community-dwelling individuals aged ≥60 years was recruited in Spain in 2008-2010 and followed-up through 2012. At baseline, participants reported alcohol consumption. HRQOL was measured with the SF-12 questionnaire, at baseline and in 2012. Results In cross-sectional analyses at baseline, compared to non-drinkers, better scores on the physical component summary (PCS) of the SF-12 were reported in moderate (β = 1.59 [95% confidence interval 0.61–2.58]) and heavy drinkers (β = 2.18 [0.57–3.79]). Better scores on the PCS were also reported by drinkers who adhered to the Mediterranean drinking pattern (MDP) (β = 1.43 [0.30–2.56]) as well as those who did not (β = 1.89 [0.79​–2.99]). However, no association was observed between average alcohol consumption or the MDP and the mental component summary (MCS) of the SF-12; or between beverage preference or drinking with meals and either the PCS or MCS scores. In prospective analyses, women who reportedly drank exclusively with meals showed better scores on the PCS than women who drank only outside of meals (β = 3.64 [0.79–6.50]).

Conclusions The small association between alcohol consumption and better physical HRQOL found at baseline was not apparent after a few years of follow-up. Medical advice on alcohol consumption cannot be grounded on its effects on HRQOL.

Keywords: Alcohol; Health-related quality of life; Ederly; Cohort study

5. Alcohol consumption in very old age and its association with survival: A matter of health and physical function

Neda Agahi, Susanne Kelfve, Carin Lennartsson, Ingemar Kåreholt

Drug and Alcohol Dependence 2016:159;240-245

Background Alcohol consumption in very old age is increasing; yet, little is known about the personal and health-related characteristics associated with different levels of alcohol consumption and the association between alcohol consumption and survival among the oldest old. Methods Nationally representative data from the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD, ages 76–101; n = 863) collected in 2010/2011 were used. Mortality was analyzed until 2014. Alcohol consumption was measured with questions about frequency and amount. Drinks per month were calculated and categorized as abstainer, light-to-moderate drinker (0.5–30 drinks/month) and heavy drinker (>30 drinks/month). Multinomial logistic regressions and Laplace regressions were performed. Results Compared to light-to-moderate drinkers, abstainers had lower levels of education and more functional health problems, while heavy drinkers were more often men, had higher levels of education, and no serious health or functional problems. In models adjusted only for age and sex, abstainers died earlier than drinkers. Among light-to-moderate drinkers, each additional drink/month was associated with longer survival, while among heavy drinkers, each additional drink/month was associated with shorter survival. However, after adjusting for personal and health-related factors, estimates were lower and no longer statistically significant. Conclusions The association between alcohol consumption and survival in very old age seems to have an inverse J-shape; abstention and heavy use is associated with shorter survival compared to light-to-moderate drinking. To a large extent, differences in survival are due to differences in baseline health and physical function.

Keywords: Alcohol; Oldest old; Survival; Mortality; Laplace

6. Relating off-premises alcohol outlet density to intentional and unintentional injuries

Christopher Morrison, Karen Smith, Paul J. Gruenewald, William R. Ponicki, Juliet P. Lee and Peter Cameron

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