Taguchi Yurie, Takei Yoshiyuki, Sasai Ryoko, Murteira Susana
Health Economics and Outcomes Research, Lundbeck Japan K.K., 5-1-4 Toranomon, Minato-ku, Tokyo 105-0001, Japan
Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-city, Mie 514-8507, Japan.
Alcohol Alcohol. 2014 Jul-Aug;49(4):439-46. doi: 10.1093/alcalc/agu025. Epub 2014 Jun 3.
To understand current awareness of, and views on, treatment of alcohol dependence in Japan.
(a) Nationwide internet-based survey of 520 individuals, consisting of 52 diagnosed alcohol-dependent (AD) persons, 154 potentially alcohol-dependent (ADP) persons, 104 family members and 106 friends/colleagues of AD persons, and 104 general individuals, derived from a consumer panel where the response rate was 64.3%. We enquired into awareness about the treatment of alcohol dependence and patient pathways through the healthcare network. (b) Nationwide internet-based survey of physicians (response rate 10.1% (2395/23,695) to ask 200 physicians about their management of alcohol use disorders).
We deduced that 10% of alcohol-dependent Japanese persons had ever been diagnosed with alcohol dependence, with only 3% ever treated. Regarding putative treatment goals, 20-25% of the AD and ADP persons would prefer to attempt to abstain, while 60-75% preferred 'reduced drinking.' A half of the responding physicians considered abstinence as the primary treatment goal in alcohol dependence, while 76% considered reduced drinking as an acceptable goal.
AD and ADP persons in Japan have low 'disease awareness' defined as 'understanding of signs, symptoms and consequences of alcohol use disorders,' which is in line with the overseas situation. The Japanese drinking culture and stigma toward alcohol dependence may contribute to such low disease awareness and current challenging treatment environment. While abstinence remains the preferred treatment goal among physicians, reduced drinking seems to be an acceptable alternative treatment goal to many persons and physicians in Japan.
了解日本目前对酒精依赖治疗的认知及看法。
(a) 对520人进行全国性网络调查,其中包括52名已确诊酒精依赖(AD)者、154名潜在酒精依赖(ADP)者、104名AD者的家庭成员、106名AD者的朋友/同事以及104名普通个体,样本来自一个消费者小组,回复率为64.3%。我们调查了对酒精依赖治疗的认知以及患者通过医疗保健网络的就医途径。(b) 对医生进行全国性网络调查(回复率为10.1%(2395/23695)),询问200名医生对酒精使用障碍的管理情况。
我们推断,10%的日本酒精依赖者曾被诊断为酒精依赖,只有3%曾接受过治疗。关于假定的治疗目标,20%-25%的AD者和ADP者倾向于尝试戒酒,而60%-75%的人倾向于“减少饮酒”。一半的受访医生认为戒酒是酒精依赖的主要治疗目标,而76%的医生认为减少饮酒是一个可接受的目标。
日本的AD者和ADP者对“酒精使用障碍的体征、症状和后果的理解”定义的“疾病认知”较低,这与海外情况一致。日本的饮酒文化和对酒精依赖的污名化可能导致这种低疾病认知和当前具有挑战性的治疗环境。虽然戒酒仍然是医生中首选的治疗目标,但减少饮酒似乎是日本许多人和医生可接受的替代治疗目标。