Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, Odense C, Denmark.
OPEN, Open Patient data Explorative Network, Odense University Hospital, Odense C, Denmark.
Alcohol Clin Exp Res. 2021 Jun;45(6):1237-1248. doi: 10.1111/acer.14615. Epub 2021 May 6.
Only a minority of individuals with problematic alcohol use ever seek alcohol treatment. Knowledge of general help-seeking behavior in the healthcare system can identify possibilities for prevention and intervention.
The current study describes healthcare use, burden of disease, and prior morbidities over a 15-year period by current alcohol use behavior among Danish adults aged 60-70. The Danish National Health Survey 2013 and the baseline assessment of the Elderly Study (2014-2016) were linked to Danish national registers to collect annual information on healthcare use and morbidity for the 15 years prior to inclusion. Participants from the 3 largest Danish municipalities were divided into 4 groups with varying drinking patterns and no recent treatment [12-month abstinent (n = 691), low-risk drinkers (n = 1978), moderate-risk drinkers (n = 602), and high-risk drinkers (n = 467)], and a group of treatment-seeking individuals with a 12-month DSM-5 alcohol use disorder (AUD; n=262). Negative binomial regression models were utilized to compare rates of healthcare use and logistic regressions were used to compare odds of diagnoses.
Low-, moderate-, and high-risk drinkers had similar rates of past healthcare utilization (low-risk mean yearly number of contacts for primary care 7.50 (yearly range 6.25-8.45), outpatient care 0.80 (0.41-1.32) and inpatient care 0.13 (0.10-0.21)). Higher rates were observed for both the 12-month abstinent group (adjusted RR = 1.16-1.26) and the group with AUD (ARR = 1.40-1.60) compared to the group with low-risk alcohol consumption. Individuals with AUD had higher odds of previous liver disease (adjusted OR = 6.30), ulcer disease (AOR = 2.83), and peripheral vascular disease (AOR 2.71). Twelve-month abstinence was associated with higher odds of diabetes (AOR = 1.97) and ulcer disease (AOR = 2.10).
Looking back in time, we found that older adults had regular healthcare contacts, with those who received treatment for AUD having had the highest contact frequency and prevalence of alcohol-related diseases. Thus, healthcare settings are suitable locations for efforts at AUD prevention and intervention.
只有少数有问题饮酒的个体寻求酒精治疗。了解一般的医疗保健系统中的求助行为可以发现预防和干预的可能性。
本研究描述了丹麦 60-70 岁成年人在 15 年内按当前饮酒行为的酒精使用情况、疾病负担和既往发病情况。丹麦国家健康调查 2013 年和老年人研究的基线评估（2014-2016 年）与丹麦国家登记册相链接，以收集纳入前 15 年每年的医疗保健使用情况和发病信息。来自丹麦 3 个最大城市的参与者分为 4 组，每组的饮酒模式不同，且最近未接受治疗[12 个月戒酒者（n=691）、低风险饮酒者（n=1978）、中风险饮酒者（n=602）和高风险饮酒者（n=467）]，以及一组接受 12 个月 DSM-5 酒精使用障碍（AUD；n=262）治疗的个体。利用负二项回归模型比较医疗保健使用的发生率，利用逻辑回归比较诊断的可能性。
低风险、中风险和高风险饮酒者的过去医疗保健利用率相似（低风险者初级保健的年平均就诊次数为 7.50 次（每年 6.25-8.45 次），门诊就诊 0.80 次（0.41-1.32 次），住院就诊 0.13 次（0.10-0.21 次））。与低风险饮酒者相比，12 个月戒酒组（调整 RR=1.16-1.26）和 AUD 组（ARR=1.40-1.60）的就诊率更高。患有 AUD 的个体既往发生肝病（调整 OR=6.30）、溃疡病（AOR=2.83）和外周血管疾病（AOR 2.71）的可能性更高。12 个月戒酒与糖尿病（AOR=1.97）和溃疡病（AOR=2.10）的可能性更高相关。
回顾过去，我们发现老年人有定期的医疗保健接触，接受 AUD 治疗的个体接触频率和酒精相关疾病的患病率最高。因此，医疗保健场所是预防和干预 AUD 的合适场所。
