Hu Huirong, Mitra Riten, Han Yuchen, Pal Subhadip, Huang Haojiang, McClain Craig J, Vatsalya Vatsalya, Kulasekera K B, Kong Maiying
Department of Bioinformatics and Biostatistics, University of Louisville School of Public Health and Information Sciences, Louisville, Kentucky, USA, 40202.
Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, Kentucky 40202, USA.
J Alcohol Drug Depend. 2022;10(5). Epub 2022 Sep 22.
Alcohol use is the leading substance use in the United States. Persons with alcohol use disorder (AUD) face enormous health consequences and family problems. Analysis of Medicaid enrollee data is critical to understand different aspects of AUD and the treatment utilization for patients with AUD. Yearly patient-level data were constructed from the Kentucky 2012-2019 Medicaid claims data. ICD-9-CM and ICD-10-CM codes were used to identify patients with AUD and their comorbid conditions, the 11-digit National Drug Codes were used to identify medication treatments, and procedure codes were used to identify psychosocial and behavioral therapies. Logistic regression models were used to examine factors that were associated with AUD prevalence and AUD treatments. The prevalence of AUD trended up over time. Patients living in metro areas, between ages 45-54, having mental disorders, tobacco use, and with a family history of alcoholism had significantly higher rates of AUD. About 60% of patients diagnosed with AUD had major depressive disorder or anxiety. The treatment utilization for AUD also trended up from 2012 to 2019; however, it was still lower than 25% in 2019. Pharmacological treatments were used in only 2.89% of AUD cases in 2012, which increased to 8.13% in 2019. Psychosocial treatments were used in only 1.59% of AUD cases in 2012 that increased to 18.95% in 2019. The prevalence of AUD trended up over years. However, the treatment utilization for AUD was lower than 25%, even as of 2019. There is an urgent need for comprehensive, evidence-based, personalized AUD treatments.
在美国，饮酒是最主要的物质使用方式。患有酒精使用障碍（AUD）的人面临着巨大的健康后果和家庭问题。分析医疗补助参保者数据对于了解AUD的不同方面以及AUD患者的治疗利用情况至关重要。年度患者层面的数据是根据肯塔基州2012 - 2019年医疗补助索赔数据构建的。使用国际疾病分类第九版临床修订本（ICD - 9 - CM）和国际疾病分类第十版临床修订本（ICD - 10 - CM）编码来识别患有AUD的患者及其共病情况，使用11位数字的国家药品编码来识别药物治疗，使用程序编码来识别心理社会和行为疗法。使用逻辑回归模型来研究与AUD患病率和AUD治疗相关的因素。AUD的患病率随时间呈上升趋势。居住在城市地区、年龄在45 - 54岁之间、患有精神障碍、使用烟草且有酗酒家族史的患者AUD发生率显著更高。约60%被诊断为AUD的患者患有重度抑郁症或焦虑症。2012年至2019年期间，AUD的治疗利用率也呈上升趋势；然而，2019年仍低于25%。2012年，仅2.89%的AUD病例使用了药物治疗，到2019年这一比例增至8.13%。2012年，仅1.59%的AUD病例接受了心理社会治疗，到2019年这一比例增至18.95%。多年来，AUD的患病率呈上升趋势。然而，即使到2019年，AUD的治疗利用率仍低于25%。迫切需要全面、基于证据且个性化的AUD治疗方法。
