Thompson Andrew, Wright Alison K, Ashcroft Darren M, van Staa Tjeerd P, Pirmohamed Munir
Wolfson Centre for Personalised Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom.
Centre for Pharmacoepidemiology and Drug Safety, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), Manchester, United Kingdom.
PLoS One. 2017 Mar 31;12(3):e0174818. doi: 10.1371/journal.pone.0174818. eCollection 2017.
This study aims to investigate the incidence and annual presentation rates of alcohol dependence in general practice in the UK, and examine age-, gender-, socioeconomic-, and region-specific variation. We conducted a retrospective 'open' cohort study using the Clinical Practice Research Datalink (CPRD), an anonymised primary care database. Prior to data extraction, a case definition for alcohol dependence in CPRD was established using 47 Read codes, which included primary alcohol dependence and consequences of alcohol dependence. Directly standardised rates for incidence and annual presentation were calculated for each year between 1990 and 2013. Rates were compared by gender, age, UK home nation, and practice-level Index of Multiple Deprivation. The directly standardised annual incidence rates were 8.3 and 3.7 per 10,000 male and female patients, respectively. The estimated annual rates of presentation per 10,000 were 17.1 for males and 7.6 for females. Female to male rate ratios were: 0.40 (95% CI: 0.39-0.41) for incident cases; and 0.37 (95% CI: 0.36-0.39) for annual presentation. Rates were highest in those aged 35-54 for both measures and across genders, and lowest in those aged over 75 years. With England as the reference nation, Northern Ireland and Scotland had significantly higher rates for both measures. Patients from the most deprived areas had the highest incidence and annual presentation rates. There is unequal distribution of patients with severe alcohol dependence across population subgroups in general practice. Given the health and economic burden associated with dependent drinking, these data will be useful in informing future public health initiatives.
本研究旨在调查英国全科医疗中酒精依赖的发病率和年就诊率，并研究年龄、性别、社会经济状况和地区差异。我们使用临床实践研究数据链（CPRD）进行了一项回顾性“开放”队列研究，CPRD是一个匿名的初级保健数据库。在提取数据之前，使用47个Read编码在CPRD中建立了酒精依赖的病例定义，其中包括原发性酒精依赖和酒精依赖的后果。计算了1990年至2013年每年的发病率和年就诊率的直接标准化率。按性别、年龄、英国地区和实践层面的多重剥夺指数对发病率进行了比较。男性和女性患者每10000人的直接标准化年发病率分别为8.3和3.7。每10000人的估计年就诊率男性为17.1，女性为7.6。女性与男性的发病率比值为：新发病例为0.40（95%可信区间：0.39 - 0.41）；年就诊率为0.37（95%可信区间：0.36 - 0.39）。在这两项指标中，35 - 54岁人群的发病率在各性别中均最高，75岁以上人群的发病率最低。以英格兰为参照地区，北爱尔兰和苏格兰在这两项指标上的发病率均显著更高。来自最贫困地区的患者发病率和年就诊率最高。在全科医疗中，严重酒精依赖患者在不同人群亚组中的分布不均。鉴于饮酒依赖相关的健康和经济负担，这些数据将有助于为未来的公共卫生举措提供参考。
