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Prior K, Baillie AJ, Newton N, Lee YY, Deady M, Guckel T, Wade L, Rapee RM, Hudson JL, Kay-Lambkin F, Slade T, Chatterton ML, Mihalopoulos C, Teesson MR, Stapinski LA. Web-based intervention for young adults experiencing anxiety and hazardous alcohol use: Study protocol for an 18-month randomized controlled trial. Addiction 2024; 119:1635-1647. [PMID: 38725272 DOI: 10.1111/add.16522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 04/08/2024] [Indexed: 08/03/2024]
Abstract
BACKGROUND AND AIMS Alcohol use and anxiety often co-occur, causing increased severity impairment. This protocol describes a randomized controlled trial (RCT) that aims to test the efficacy and cost-effectiveness of a web-based, self-guided alcohol and anxiety-focused program, compared with a web-based brief alcohol-focused program, for young adults who drink at hazardous levels and experience anxiety. It will also test moderators and mechanisms of change underlying the intervention effects. DESIGN This RCT will be conducted with a 1:1 parallel group. SETTING The study will be a web-based trial in Australia. PARTICIPANTS Individuals aged 17-30 years who drink alcohol at hazardous or greater levels and experience at least mild anxiety (n = 500) will be recruited through social media, media (TV, print) and community networks. INTERVENTION AND COMPARATOR Participants will be randomly allocated to receive a web-based, integrated alcohol-anxiety program plus technical and motivational telephone/e-mail support (intervention) or a web-based brief alcohol-feedback program (control). MEASUREMENTS Clinical measures will be assessed at baseline, post-intervention (2 months), 6 months (primary end-point), 12 months and 18 months. Co-primary outcomes are hazardous alcohol consumption and anxiety symptom severity. Secondary outcomes are binge-drinking frequency; alcohol-related consequences; depression symptoms; clinical diagnoses of alcohol use or anxiety disorder (at 6 months post-intervention), health-care service use, educational and employment outcomes; and quality of life. Mediators and moderators will also be assessed. Efficacy will be tested using mixed models for repeated measures within an intention-to-treat framework. The economic evaluation will analyze individual-level health and societal costs and outcomes of participants between each trial arm, while mediation models will test for mechanisms of change. COMMENTS This will be the first trial to test whether a developmentally targeted, web-based, integrated alcohol-anxiety intervention is effective in reducing hazardous alcohol use and anxiety severity among young adults. If successful, the integrated alcohol-anxiety program will provide an accessible intervention that can be widely disseminated to improve wellbeing of young adults, at minimal cost.
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Affiliation(s)
- Katrina Prior
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | | | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Yong Yi Lee
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- School of Public Health, The University of Queensland, Brisbane, Australia
- Queensland Centre for Mental Health Research, Brisbane, Australia
| | - Mark Deady
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Tara Guckel
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Laura Wade
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Ronald M Rapee
- Centre for Lifespan Health and Wellbeing, Macquarie University, Sydney, Australia
| | - Jennifer L Hudson
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Frances Kay-Lambkin
- University of Newcastle and Hunter Medical Research Institute, Newcastle, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Mary Lou Chatterton
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Cathrine Mihalopoulos
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Maree R Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Lexine A Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
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Christensen E, Albertella L, Chamberlain SR, Brydevall M, Suo C, Grant JE, Yücel M, Lee RSC. The neurocognitive correlates of non-substance addictive behaviors. Addict Behav 2024; 150:107904. [PMID: 37984220 DOI: 10.1016/j.addbeh.2023.107904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/19/2023] [Accepted: 11/02/2023] [Indexed: 11/22/2023]
Abstract
Neurocognitive deficits have been implicated as transdiagnostic risk markers of substance use disorders. However, these have yet to be comprehensively evaluated in other, non-substance addictions. In a large, general community sample (N = 475) the present study evaluated the neurocognitive correlates of problem alcohol use and three non-substance-related addictive behaviors: addictive eating (AE), problematic pornography use (PPU), and problematic use of the internet (PUI), to identify potential shared and distinct neurocognitive correlates. A sample of Australian residents (54.4 % female M[SD] age = 32.4[11.9] years) completed a comprehensive online assessment of neurocognitive tasks tapping into eight distinct expert-endorsed domains purportedly associated with addiction. Multiple linear regressions with bootstrapping were used to examine associations among each addictive behavior of interest and neurocognition, trait impulsivity, and compulsivity, as well as key covariates. Neurocognition was differentially associated with each addictive behavior. None of the neurocognitive domains were significantly associated with problematic alcohol use or AE (p >.05), poorer performance monitoring was significantly associated with higher levels of PPU and PUI (β = -0.10, p =.049; β = -0.09, p =.028), and a preference for delayed gratification was associated with more severe PUI (β = -0.10, p =.025). Our findings have theoretical implications for how we understand non-substance addiction and suggest the need for a more nuanced approach to studying addictive behaviors that take into account the underlying neurocognitive mechanisms associated with each type of addiction.
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Affiliation(s)
- Erynn Christensen
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia.
| | - Lucy Albertella
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Samuel R Chamberlain
- Department of Psychiatry, University of Southampton, Southampton, the United Kingdom of Great Britain and Northern Ireland; Southern Health NHS Foundation Trust, Southampton, the United Kingdom of Great Britain and Northern Ireland
| | - Maja Brydevall
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Chao Suo
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Jon E Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Pritzker School of Medicine, Chicago, IL, USA
| | - Murat Yücel
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia; QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Rico Sze Chun Lee
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia; Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
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3
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Fletcher K, Moran-Pryor A, Robert-Hendren D. Preliminary Clinical Outcomes of the Hello Sunday Morning Alcohol and Wellbeing Self-Assessment: Feasibility and Acceptability Study. JMIR Form Res 2023; 7:e48245. [PMID: 37874615 PMCID: PMC10630865 DOI: 10.2196/48245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/25/2023] [Accepted: 09/23/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Alcohol-related injuries and diseases are a leading cause of morbidity and mortality worldwide. Early intervention is essential given the chronic, relapsing nature of alcohol use disorders. There is significant potential for widely accessible web-based screening tools to help individuals determine where they stand in terms of alcohol use and provide support recommendations. Screening and brief interventions (SBIs) provide individuals with a stigma-free opportunity to learn and think about the potential risks of drinking and prompt help-seeking behavior by incorporating behavior change techniques. Furthermore, as excessive alcohol use and mental health problems often occur concurrently, SBIs for both conditions simultaneously can potentially address a critical gap in alcohol and mental health treatment. OBJECTIVE We investigated the feasibility, acceptability, and clinical outcomes of participants completing the Alcohol and Wellbeing Self-assessment (A&WS), a web-based SBI. METHODS The A&WS is freely available on the Hello Sunday Morning website as part of an uncontrolled observational prospective study. Feasibility was assessed based on the number of respondents who commenced and subsequently completed the A&WS. Acceptability was measured via participant feedback to determine overall satisfaction, perceived helpfulness, and likelihood of recommending the A&WS to others. Clinical outcomes were measured in two ways: (1) self-reported changes in alcohol consumption (Alcohol Use Disorders Identification Test score) or psychological distress (Kessler Psychological Distress Scale score) over time and (2) help seeking-both self-reported and immediate web-based help seeking. Preliminary baseline data collected for the first 9 months (March 2022 to December 2022) of the study were reported, including the 3-month follow-up outcomes. RESULTS A total of 17,628 participants commenced the A&WS, and of these, 14,419 (81.8%) completed it. Of those 14,419 who completed the A&WS, 1323 (9.18%) agreed to participate in the follow-up research. Acceptability was high, with 78.46% (1038/1323) reporting high satisfaction levels overall; 95.62% (1265/1323) found the A&WS easy to use and would recommend the tool to others. The 1-, 2-, and 3-month follow-ups were completed by 28.57% (378/1323), 21.09% (279/1323), and 17.61% (233/1323) of the participants, respectively. Significant reductions in the Alcohol Use Disorders Identification Test Consumption subscale (P<.001) and Kessler Psychological Distress Scale scores (P<.001) were observed over the 3-month follow-up period. CONCLUSIONS Our results suggest that the A&WS is a highly feasible and acceptable digital SBI that may support individuals in making changes to their alcohol consumption and improve their psychological well-being. In the absence of a control group, positive clinical outcomes cannot be attributed to the A&WS, which should now be subjected to a randomized controlled trial. This scalable, freely available tool has the potential to reach a large number of adults who might not otherwise access help while complementing the alcohol and mental health treatment ecosystem.
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Affiliation(s)
- Kathryn Fletcher
- Hello Sunday Morning, Sydney, Australia
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
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Colbert S, Wilkinson C, Thornton L, Feng X, Campain A, Richmond R. Cross-sectional survey of a convenience sample of Australians who use alcohol home delivery services. Drug Alcohol Rev 2023; 42:986-995. [PMID: 36853829 PMCID: PMC10947259 DOI: 10.1111/dar.13627] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 01/10/2023] [Accepted: 01/23/2023] [Indexed: 03/01/2023]
Abstract
INTRODUCTION Online alcohol purchasing and home delivery has increased in recent years, accelerated by the onset of the coronavirus disease 2019 pandemic. This article aims to investigate the purchasing and drinking behaviour of Australians who use online alcohol delivery services. METHOD A cross-sectional self-report survey with a convenience sample of 1158 Australians ≥18 years (49.3% female) who used an online alcohol delivery service in the past 3 months, recruited through paid social media advertisements from September to November 2021. Quota sampling was used to obtain a sample with age and gender strata proportional to the Australian adult population. Descriptive statistics were generated and logistic regression used to explore variables that predict hazardous/harmful drinking (Alcohol Use Disorders Identification Test score ≥8). RESULTS One-in-five (20.1%, 95% confidence interval [CI] 17.8-22.5) participants had used an alcohol delivery service to extend a home drinking session because they had run out of alcohol and wanted to continue drinking and, of these, one-third (33.9%, 95% CI 27.9-40.4) indicated that if the service was not available they would have stopped drinking. Using delivery services in this way was associated with six times higher odds of drinking at hazardous/harmful levels (odds ratio 6.26, 95% CI 3.78-10.36). Participants ≤25 years were significantly more likely to report never having their identification verified when receiving their alcohol delivery at the door compared with purchasing takeaway alcohol in-person at a bottle shop (p < 0.001, McNemar). DISCUSSION AND CONCLUSION Given the risks associated with alcohol delivery, regulation of these services should be improved to meet the same standards as bricks-and-mortar bottle shops.
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Affiliation(s)
| | - Claire Wilkinson
- Drug Policy Modelling ProgramSocial Policy Research Centre, UNSW SydneySydneyAustralia
- Centre for Alcohol Policy ResearchLa Trobe UniversityMelbourneAustralia
| | - Louise Thornton
- School of Population HealthUNSW SydneySydneyAustralia
- The Matilda Centre for Research in Mental Health and Substance UseThe University of SydneySydneyAustralia
| | - Xiaoqi Feng
- School of Population HealthUNSW SydneySydneyAustralia
- Population Wellbeing and Environment Research Lab (PowerLab)University of WollongongWollongongAustralia
- The George Institute for Global HealthSydneyAustralia
| | - Anna Campain
- The George Institute for Global HealthSydneyAustralia
- Faculty of MedicineUNSW SydneySydneyAustralia
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Abo Hamza E, Yoon A, Liu L, Garg A, Richard Y, Frydecka D, Helal A, Moustafa AA. The Relationship between Mindfulness and Readiness to Change in Alcohol Drinkers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095690. [PMID: 37174208 PMCID: PMC10178867 DOI: 10.3390/ijerph20095690] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 05/15/2023]
Abstract
Mindfulness is a multi-faceted construct that involves paying attention to thoughts and emotions without automatically reacting and being critical of them. Recent research has suggested that mindfulness might play an important role in reducing problematic alcohol use. Further, Readiness to Change (RTC) is related to motivation to change drinking behaviours. The RTC scale identifies motivation to change drinking behaviours including Precontemplation, Contemplation, and Action stages. The current study investigated, for the first time, the relationship between mindfulness (and its facets) and RTC in relation to drinking behaviours. Undergraduate students from Western Sydney University (N = 279) were screened for drinking levels using the Alcohol Use Disorder Identification Test (AUDIT) and then completed the Readiness to Change Questionnaire (RCT) and the Five Facets Mindfulness Questionnaire (FFMQ), which includes the following facets: Acting with Awareness, Non-Judging of Inner Experience, Non-Reactivity to Inner Experience, Describing, and Observing. Results show that overall, mindfulness and its facets negatively correlated with RTC. Multiple regression analysis further showed that Awareness and Non-Judgement facets negatively predicted RTC. These findings provide insight into how the facets of mindfulness interact with the drinking motives of individuals and their intentions to change drinking behaviours. Based on these findings, we recommend the incorporation of mindfulness techniques in interventions targeting problematic drinking.
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Affiliation(s)
- Eid Abo Hamza
- College of Education, Humanities & Social Sciences, Al Ain University, Abu Dhabi P.O. Box 64141, United Arab Emirates
- Faculty of Education, Tanta University, Tanta 31527, Egypt
| | - Adam Yoon
- School of Psychology, Western Sydney University, Sydney, NSW 2751, Australia
| | - Liquan Liu
- School of Psychology, Western Sydney University, Sydney, NSW 2751, Australia
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Milperra, NSW 2751, Australia
| | - Anchal Garg
- School of Psychology, Faculty of Society and Design, Bond University, Gold Coast, QLD 4229, Australia
| | - Yuliya Richard
- Blue Horizon Counselling and Mediation, Sydney, NSW 2065, Australia
| | - Dorota Frydecka
- Department of Psychiatry, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Ahmed Helal
- Faculty of Education, Tanta University, Tanta 31527, Egypt
| | - Ahmed A Moustafa
- School of Psychology, Faculty of Society and Design, Bond University, Gold Coast, QLD 4229, Australia
- Department of Human Anatomy and Physiology, Faculty of Health Sciences, University of Johannesburg, Johannesburg P.O. Box 524, South Africa
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6
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Leung T, Wright C, Kuntsche E, Kuntsche S. The Effects of a Web-Based Intervention to Reduce Alcohol Consumption Among Middle-Aged Women: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e34842. [PMID: 36729575 PMCID: PMC9936363 DOI: 10.2196/34842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 07/27/2022] [Accepted: 07/30/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND In the last decade, alcohol consumption among middle-aged women (40-65 years old) in Australia increased, despite declines in overall population consumption. Web-based, brief interventions are promising for reducing alcohol consumption, with efficacy shown in a wide range of populations. However, no published interventions have been designed specifically for and tested with middle-aged women. OBJECTIVE This study aims to design and implement a web-based intervention intended to reduce alcohol consumption among middle-aged women. METHODS The study is a 3-arm randomized controlled trial with a web-based intervention plus ecological momentary assessment (EMA) group compared to an EMA-only and a pre-post only control group. The study is aimed at middle-aged women, defined as women aged between 40 and 65 years, who consume alcohol at least weekly or who have consumed 4 or more drinks on 1 occasion in the last month. The intervention aims to reduce alcohol consumption through 4 modules that provide information on the health impacts of alcohol, mindfulness, social influences, and alcohol marketing. Intervention participants will also fill out biweekly EMA assessments. The comparators are EMA-only and pre-post control only. The primary outcome is alcohol consumption at 8 weeks compared between groups. Secondary outcomes are awareness of alcohol-related harms, readiness to change alcohol consumption, health status, mental health, and social support. RESULTS Ethics approval for this project was received on September 11, 2019. The trial was registered on August 14, 2020. Recruitment has commenced, and the expected results will be available in 2022. CONCLUSIONS This web-based intervention aims to reduce alcohol consumption among middle-aged women, a currently understudied cohort in alcohol research. TRIAL REGISTRATION Australia New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620000814976; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12620000814976. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/34842.
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Affiliation(s)
| | - Cassandra Wright
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia.,Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.,Burnet Institute, Melbourne, Australia
| | - Emmanuel Kuntsche
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Sandra Kuntsche
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
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Kurshed AAM, Vincze F, Pikó P, Kósa Z, Sándor J, Ádány R, Diószegi J. Alcohol consumption patterns of the Hungarian general and Roma populations. Front Public Health 2023; 10:1003129. [PMID: 36703826 PMCID: PMC9871455 DOI: 10.3389/fpubh.2022.1003129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 12/15/2022] [Indexed: 01/11/2023] Open
Abstract
Introduction Harmful alcohol use is a significant public health problem worldwide, though the alcohol-related burden affects disproportionately certain populations and ethnic minorities, with the WHO European Region being the most heavily affected and putting an increased risk on Roma populations. This ethnic minority group is the largest and most vulnerable ethnic minority in Europe and Hungary as well. Methods The present study aims to describe and compare the alcohol consumption behaviors of the Hungarian general and Roma populations using the Alcohol Use Disorders Identification Test (AUDIT), which provides a comprehensive view of alcohol consumption behavior. In addition, a decomposition analysis was performed when the multivariate logistic or Poisson regression model showed significant differences between the two samples. Results Our findings suggest that Roma people in our study sample experience more alcohol-related harm, even when considering past problems. The decomposition analysis revealed that gender and relationship status differences act more intensely among Roma than non-Roma when considering alcohol-related harm. Discussion Equalizing these differences would be expected to reduce the Hungarian general and Roma populations' alcohol-related harm frequency gap. Investigating alcohol-attributed harms at the ethnicity level provides important information to identify high-risk groups and, thus, to design and implement more targeted and accessible interventions for alcohol problems.
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Affiliation(s)
- Ali Abbas Mohammad Kurshed
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary,Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary,Institute of Nutrition and Food Science, University of Dhaka, Dhaka, Bangladesh
| | - Ferenc Vincze
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Péter Pikó
- ELKH-DE Public Health Research Group, Department of Public Health and Epidemiology, Faculty of Medicine University of Debrecen, Debrecen, Hungary
| | - Zsigmond Kósa
- Department of Health Methodology and Public Health, Faculty of Health, University of Debrecen, Nyíregyháza, Hungary
| | - János Sándor
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Róza Ádány
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary,ELKH-DE Public Health Research Group, Department of Public Health and Epidemiology, Faculty of Medicine University of Debrecen, Debrecen, Hungary
| | - Judit Diószegi
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary,*Correspondence: Judit Diószegi ✉
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Brummer J, Bloomfield K, Karriker-Jaffe KJ, Pedersen MM, Hesse M. Using the alcohol use disorders identification test to predict hospital admission for alcohol-related conditions in the Danish general population: a record-linkage study. Addiction 2023; 118:86-94. [PMID: 35993432 PMCID: PMC10087303 DOI: 10.1111/add.16034] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 08/10/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Most studies validating the alcohol use disorders identification test (AUDIT) have either assessed its factor structure and/or test-retest reliability or used diagnostic interviews as validators of current alcohol use disorders. The aim of the present study was to determine whether AUDIT and AUDIT-Consumption (AUDIT-C) scores are associated with subsequent risk of hospital admission for alcohol-related disorders and diseases (ARDDs). DESIGN We used a historical cohort study. Using national registers, survey respondents were tracked from 1 September 2011 to hospitalization for an ARDD, emigration, death, or 31 December 2018, whichever occurred first. SETTING Denmark. PARTICIPANTS Respondents (n = 4522) from a Danish national survey conducted in autumn 2011. MEASUREMENTS Outcome was incident ARDD admission recorded in the National Patient Register. Predictors were AUDIT and AUDIT-C scores, and covariates were age, gender, highest level of education and previous psychiatric disorder. FINDINGS During the study period, 56 respondents had a first-time ARDD admission. Respondents who scored above the 8-point AUDIT cut-off and respondents who scored above the 5-point AUDIT-C cut-off had a significantly increased risk of being admitted for an ARDD compared with respondents who scored below the cut-offs, (AUDIT: hazard ratio (HR), 4.72; 95% CI, 2.59-8.60; AUDIT-C: HR, 7.97; 95% CI, 3.66-17.31). CONCLUSIONS Scores above alcohol use disorders identification test (AUDIT) and AUDIT-Consumption (AUDIT-C) cut-offs are associated with an increased risk of long-term alcohol-related hospital admissions. At widely used cut-offs, the AUDIT-C is a better predictor of alcohol-related hospitalizations among members of the general population than the full AUDIT.
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Affiliation(s)
- Julie Brummer
- Centre for Alcohol and Drug Research, Aarhus University, Copenhagen, Denmark
| | - Kim Bloomfield
- Centre for Alcohol and Drug Research, Aarhus University, Copenhagen, Denmark.,Alcohol Research Group, Public Health Institute, Emeryville, CA, USA.,Institute of Biometry and Clinical Epidemiology, Charité- Universitaetsmedizin Berlin, Berlin, Germany
| | | | | | - Morten Hesse
- Centre for Alcohol and Drug Research, Aarhus University, Copenhagen, Denmark
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Callinan S, Livingston M, Dietze P, Gmel G, Room R. Age-based differences in quantity and frequency of consumption when screening for harmful alcohol use. Addiction 2022; 117:2431-2437. [PMID: 35466478 PMCID: PMC9544839 DOI: 10.1111/add.15904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 04/02/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Survey questions on usual quantity and frequency of alcohol consumption are regularly used in screening tools to identify drinkers requiring intervention. The aim of this study was to measure age-based differences in quantity and frequency of alcohol consumption on the Alcohol Use Disorders Identification Test (AUDIT) and how this relates to the prediction of harmful or dependent drinking. DESIGN Cross-sectional survey. SETTING Australia. PARTICIPANTS Data were taken from 17 399 respondents who reported any alcohol consumption in the last year and were aged 18 and over from the 2016 National Drug Strategy Household Survey, a broadly representative cross-sectional survey on substance use. MEASUREMENT Respondents were asked about their frequency of consumption, usual quantity per occasion and the other items of the AUDIT. FINDINGS In older drinkers, quantity per occasion [β = 0.53, 95% confidence interval (CI) = 0.43, 0.64 in 43-47-year-olds as an example] was a stronger predictor of dependence than frequency per occasion (β = 0.24, 95% CI = 0.17, 0.31). In younger drinkers the reverse was true, with frequency a stronger predictor (β = 0.54, 95% CI = 0.39, 0.69 in 23-27-year-olds) than quantity (β = 0.26, 95% CI = 0.18, 0.34 in 23-27-year-olds). Frequency of consumption was not a significant predictor of dependence in respondents aged 73 years and over (β = -0.03, 95% CI = -0.08, 0.02). Similar patterns were found when predicting harmful drinking. Despite this, as frequency of consumption increased steadily with age, the question on frequency was responsible for at least 65% of AUDIT scores in drinkers aged 53 years and over. CONCLUSIONS In younger drinkers, frequent drinking is more strongly linked to dependence and harmful drinking subscale scores on the Alcohol Use Disorders Identification Test (AUDIT) than quantity per occasion, yet quantity per occasion has a stronger influence on the overall AUDIT score in this group. In older drinkers, frequency of consumption is not always a significant predictor of the AUDIT dependence subscale and is a weak predictor of the harmful drinking subscale.
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Affiliation(s)
- Sarah Callinan
- Centre for Alcohol Policy ResearchLa Trobe UniversityBundooraAustralia
| | - Michael Livingston
- Centre for Alcohol Policy ResearchLa Trobe UniversityBundooraAustralia,National Drug Research InstituteCurtin University MelbourneAustralia,Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
| | - Paul Dietze
- National Drug Research InstituteCurtin University MelbourneAustralia,Behaviours and Health Risks ProgramBurnet InstituteMelbourneAustralia,Addiction MedicineLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Gerhard Gmel
- Addiction MedicineLausanne University Hospital and University of LausanneLausanneSwitzerland,Research DepartmentAddiction SwitzerlandLausanneSwitzerland,Centre for Addiction and Mental HealthInstitute for Mental Health Policy ResearchTorontoCanada
| | - Robin Room
- Centre for Alcohol Policy ResearchLa Trobe UniversityBundooraAustralia,Centre for Social Research on Alcohol and DrugsStockholm UniversityStockholmSweden
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10
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Alcohol Consumption in Chinese Young Adult Gamers: Factor Structure and Measurement Invariance of the Alcohol Use Disorders Identification Test (AUDIT). Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00866-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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11
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Florek S, Piegza M, Dębski P, Gorczyca P, Pudlo R. The Influence of Sociodemographic Factors on Symptoms of Anxiety, the Level of Aggression and Alcohol Consumption in the Time of the COVID-19 Pandemic among Polish Respondents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127081. [PMID: 35742329 PMCID: PMC9222902 DOI: 10.3390/ijerph19127081] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/02/2022] [Accepted: 06/07/2022] [Indexed: 12/10/2022]
Abstract
The COVID-19 pandemic has had a significant impact on the mental health of most of the world's population. The authors of this study decided to identify differences in the intensity of anxiety, aggression and alcohol consumption within the study population. The study was conducted via an Internet survey. It uses Polish adaptations of international scales to assess anxiety (GAD-7), aggression (Buss and Perry Aggression Scale) and alcohol consumption (AUDIT test). A total of 538 people were examined. The surveyed group of respondents does not reflect the structure of Polish society. The group of surveyed women scored higher than men in terms of anxiety, as well as anger and hostility. The examined men were characterized by higher results of alcohol consumption and physical aggression. People between 18 and 49 years of age consumed significantly more alcohol than people aged 50 and over. People aged 18-29 obtained statistically significantly higher scores in generalized aggression and hostility. The relationships between the studied parameters do not differ significantly from those presented in other studies. People under the age of 50 are the group most exposed to the harmful effects of alcohol. Women between the ages of 30 and 49 are most vulnerable to the negative mental health effects of the COVID-19 pandemic. There is a need for further research studies in which the studied group will obtain a greater degree of compliance with the structure of Polish society.
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Wallace J, Xiao Y, Howell J, Thompson A, Allard N, Adamson E, Richmond J, Hajarizadeh B, Eagle M, Doyle J, Hellard M. Understanding how to live with hepatitis B: a qualitative investigation of peer advice for Chinese people living with hepatitis B in Australia. BMC Public Health 2022; 22:536. [PMID: 35303855 PMCID: PMC8932317 DOI: 10.1186/s12889-022-12907-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 03/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hepatitis B is a chronic viral infection, a leading cause of primary liver cancer and identified as a major public health priority by the World Health Organization. Despite a high proportion of people in Australia who have been diagnosed with hepatitis B, significant gaps remain in health care access and in accurate knowledge about hepatitis B. Most people with hepatitis B in Australia were born in China, where the infection has an intergenerational impact with significant social implications resulting from the infection. Understanding how people of Chinese ethnicity with hepatitis B understand and respond to hepatitis B is imperative for reducing morbidity, mortality, and the personal and social impact of the infection. METHODS Qualitative semi-structured interviews with people with hepatitis B of Chinese ethnicity recruited through a specialist service identified the advice people with hepatitis B thought was important enough to inform the experience of people newly diagnosed with hepatitis B. A thematic analysis of the data privileged the lived experience of participants and their personal, rather than clinical, explanations of the virus. RESULTS Hepatitis B infection had psychological and physical consequences that were informed by cultural norms, and to which people had responded to with significant behavioural change. Despite this cohort being engaged with specialist clinical services with access to the most recent, comprehensive, and expert information, much of the advice people with hepatitis B identified as important for living with hepatitis B was not based on biomedical understandings. Key suggestions from people with hepatitis B were to form sustainable clinical relationships, develop emotional resilience, make dietary changes, regulate energy, and issues related to disclosure. CONCLUSIONS The study highlights conflicts between biomedical and public health explanations and the lived experience of hepatitis B among people of Chinese ethnicity in Australia. Beliefs about hepatitis B are embedded within cultural understandings of health that can conflict with bio-medical explanations of the infection. Acknowledging these perspectives provides for insightful communication between health services and their clients, and the development of nuanced models of care informed by the experience of people with hepatitis B.
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Affiliation(s)
- Jack Wallace
- Burnet Institute, Melbourne, VIC, 3004, Australia. .,La Trobe University, Bundoora, VIC, 3086, Australia. .,Centre for Social Research in Health, University of New South Wales Sydney, Kensington, NSW, 2052, Australia.
| | - Yinzong Xiao
- Burnet Institute, Melbourne, VIC, 3004, Australia.,Department of Gastroenterology, St Vincent's Hospital, Fitzroy, VIC, 3065, Australia.,University of Melbourne, Parkville, VIC, 3010, Australia
| | - Jess Howell
- Burnet Institute, Melbourne, VIC, 3004, Australia.,Department of Gastroenterology, St Vincent's Hospital, Fitzroy, VIC, 3065, Australia.,University of Melbourne, Parkville, VIC, 3010, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Alex Thompson
- Department of Gastroenterology, St Vincent's Hospital, Fitzroy, VIC, 3065, Australia.,University of Melbourne, Parkville, VIC, 3010, Australia
| | - Nicole Allard
- World Health Organization Collaborating Centre for Viral Hepatitis, The Doherty Institute, Melbourne, VIC, 3004, Australia
| | | | - Jacqui Richmond
- Burnet Institute, Melbourne, VIC, 3004, Australia.,La Trobe University, Bundoora, VIC, 3086, Australia
| | - Behzad Hajarizadeh
- Kirby Institute, University of New South Wales Sydney, Kensington, NSW, 2052, Australia
| | | | - Joseph Doyle
- Burnet Institute, Melbourne, VIC, 3004, Australia.,Department of Infectious Diseases, The Alfred and Monash University, Melbourne, VIC, 3004, Australia
| | - Margaret Hellard
- Burnet Institute, Melbourne, VIC, 3004, Australia.,University of Melbourne, Parkville, VIC, 3010, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.,Department of Infectious Diseases, The Alfred and Monash University, Melbourne, VIC, 3004, Australia
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13
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Wong RXY, Farrell M, Degenhardt L, Memedovic S, Harvey SB, Petrie K. Substance use among vocational trainees in Australia: differences between medical specialties. Intern Med J 2022. [PMID: 35257451 DOI: 10.1111/imj.15729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 02/06/2022] [Accepted: 02/25/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND There have been few large-scale nationally representative studies on the prevalence of substance use among doctors. Additionally, the association of different medical specialties with the use of different substances requires further research. AIMS This study aimed to investigate how the use of alcohol, tobacco and illicit drugs varied between junior doctors enrolled in different specialty training programmes. METHODS A secondary analysis was conducted on a national survey of 12,252 Australian doctors. The population of interest was junior doctors currently enrolled in a specialty training programme, termed Vocational Trainees (VTs) (n=1890, 15.4% overall sample). Self-report prevalence of current alcohol, tobacco and illicit drug use were assessed, and hazardous alcohol use was assessed using the Alcohol Use Disorders Identification Test (AUDIT). Logistic regression was used to examine the association between specialty and substance use, adjusting for demographic characteristics when required. RESULTS One in six VTs reported hazardous levels of alcohol use (n=268, 17.3%). After adjusting for confounders, the association between the prevalence of alcohol use and the specialties of emergency medicine/ICU (OR=2.15, 95% CI:1.40-3.32, p<0.001), anaesthetics (OR=2.53, 95% CI:1.35-4.76, p=0.004) and obstetrics/gynaecology (OR=1.89, 95% CI:1.19-3.02, p=0.007) remained significant. No significant associations were found between tobacco use/illicit drug use/hazardous alcohol use and medical specialty. CONCLUSIONS While rates of substance use and hazardous alcohol use in VTs are similar, if not lower, to the general population, it poses a concern that there are higher rates of alcohol use in certain medical specialties. This article is protected by copyright. All rights reserved.
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Affiliation(s)
| | - Michael Farrell
- National Drug and Alcohol Research Centre (NDARC), University of Sydney, Sydney, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre (NDARC), University of Sydney, Sydney, Australia
| | - Sonja Memedovic
- National Drug and Alcohol Research Centre (NDARC), University of Sydney, Sydney, Australia
| | - Samuel B Harvey
- Black Dog Institute, University of New South Wales, Randwick, Australia
| | - Katherine Petrie
- Black Dog Institute, University of New South Wales, Randwick, Australia.,School of Psychiatry, University of New South Wales, Sydney, Australia
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Rubin M, Hutton A. Binge Drinkers Shouldn’t Set Their Own Alcohol Reduction Goals! Evaluating the Effectiveness of Different Goal-Based Alcohol Reduction Interventions among Young People. ALCOHOLISM TREATMENT QUARTERLY 2022. [DOI: 10.1080/07347324.2022.2037486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Mark Rubin
- School of Psychological Sciences, The University of Newcastle, Callaghan, Australia
| | - Alison Hutton
- School of Nursing and Midwifery, The University of Newcastle, Callaghan, Australia
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15
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Stapinski LA, Prior K, Newton NC, Biswas RK, Kelly E, Deady M, Lees B, Teesson M, Baillie AJ. Are we making Inroads? A randomized controlled trial of a psychologist-supported, web-based, cognitive behavioral therapy intervention to reduce anxiety and hazardous alcohol use among emerging adults. EClinicalMedicine 2021; 39:101048. [PMID: 34622183 PMCID: PMC8478683 DOI: 10.1016/j.eclinm.2021.101048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 07/09/2021] [Accepted: 07/13/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Anxiety and alcohol use disorders are common and disabling conditions that people typically endure for many years before accessing treatment. The link between anxiety and alcohol use is well-established, with these issues commonly emerging and/or escalating during emerging adulthood. This randomized controlled trial evaluated a psychologist-supported, web-based intervention, designed with and for emerging adults, that aims to promote adaptive coping strategies, and prevent anxiety and alcohol use from progressing to chronic, mutually-reinforcing disorders. METHODS Between December 2017 and September 2018, 123 emerging adults (aged 17-24) reporting anxiety symptoms and hazardous alcohol use were randomized to receive the Inroads or control (assessment plus alcohol information) intervention. The Inroads program combined five web-based cognitive behavioral therapy modules with weekly psychologist support via email/phone. Primary outcomes were alcohol consumption, severity of alcohol-related consequences, and general anxiety symptoms, assessed at baseline, 2 and 6-months post-baseline. Secondary outcomes included hazardous alcohol use and social anxiety. Trial Registration: Prospectively registered in the Australian New Zealand Clinical Trials Registry, ACTRN12617001609347. FINDINGS Alcohol consumption and associated consequences reduced in both groups, with the Inroads group reporting greater alcohol reductions by 6-month follow-up (mean difference -0.74, 95% CI: -1.47 to -0.01, d = 0.24). Relative to controls, hazardous alcohol use reduced among Inroads participants at both follow-ups (2-month mean difference -2.14, 95% CI: -4.06 to -0.22). Inroads participants also reported reduced symptoms of general (mean difference -3.06, 95% CI: -4.97 to -1.15, d = 0.88) and social anxiety (mean difference -3.21, 95% CI: -6.34 to -0.07, d = 0.32) at 2-month follow-up, with improvements in social anxiety sustained at 6-months. INTERPRETATION The Inroads program demonstrated beneficial effects on alcohol consumption, hazardous alcohol use, and anxiety symptoms. The web-based format is aligned with youth treatment preferences and can be delivered at scale to achieve wide dissemination and reduce the significant burden associated with these chronic, mutually reinforcing conditions. FUNDING Australian Rotary Health, Australian National Health and Medical Research Council.
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Affiliation(s)
- Lexine A. Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, The University of Sydney, Camperdown, NSW 2006, Australia
- Corresponding author.
| | - Katrina Prior
- The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Nicola C. Newton
- The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Raaj Kishore Biswas
- The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, The University of Sydney, Camperdown, NSW 2006, Australia
- Transport and Road Safety (TARS) Research Centre, School of Aviation, University of New South Wales, Sydney 2052, Australia
| | - Erin Kelly
- The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Mark Deady
- Black Dog Institute, University of New South Wales, Sydney 2052, Australia
| | - Briana Lees
- The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Andrew J. Baillie
- Sydney School of Health Sciences, University of Sydney, Sydney 2006, Australia
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16
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O'Brien H, Di Rico R, Dean E, Smoker G, Lloyd-Jones M, McKechnie M, Dietze PM, Doyle JS. Screening for risky drinkers among hospitalised inpatients using the AUDIT: A feasibility, point prevalence and data linkage study. Drug Alcohol Rev 2021; 41:293-302. [PMID: 34184348 DOI: 10.1111/dar.13343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 06/05/2021] [Accepted: 06/07/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Risky drinking frequently remains undiagnosed or untreated, including in hospitalised inpatients. Using the Alcohol Use Disorders Identification Test (AUDIT), we assessed the feasibility of screening for risky drinking and whether screening results aligned with alcohol-attributable diagnoses in an inpatient population. METHODS We conducted a cross-sectional survey across a tertiary health service in Melbourne, Australia. Researchers collected demographics, AUDIT scores and acceptability from all eligible adult inpatients available on day of survey. Main outcomes were prevalence of risky drinking (AUDIT ≥8), mean AUDIT score and patient acceptability. Identification of risky drinking by the abbreviated 'AUDIT-C' or discharge diagnoses (extracted by data-linkage with medical records) was compared. RESULTS Of 473 eligible inpatients, 61% (n = 289) participated, 22% (n = 103) were unavailable and 17% (n = 81) declined. Median age was 64 years (IQR = 48, 76); 54% (n = 157) were male. Mean AUDIT score was 4.4 (SD = 5.5). Risky drinking prevalence was 20% (n = 57), 2% (n = 7) had scores suggestive of dependence (AUDIT ≥20, a subset of risky drinkers). Odds of risky drinking were reduced in females (OR 0.19, 95% CI 0.09, 0.41; P < 0.001) and participants ≥70 years (OR 0.22, 95% CI 0.07, 0.71; P = 0.01). Alcohol-attributable diagnoses did not consistently align with risky drinking, with half of inpatients with wholly attributable diagnoses classified as low risk. Most inpatients considered screening acceptable (89%, n = 256). DISCUSSION AND CONCLUSIONS Pre-admission risky drinking was evident in one-fifth of hospital inpatients, but alcohol-attributable diagnoses were unreliable proxy measures of risky drinking. Screening in-patients with the AUDIT was acceptable to inpatients and can be feasibly implemented in an Australian tertiary hospital setting.
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Affiliation(s)
- Helen O'Brien
- Program for Behaviours and Health Risks, Burnet Institute, Melbourne, Australia
| | - Rehana Di Rico
- Program for Behaviours and Health Risks, Burnet Institute, Melbourne, Australia.,Epworth Monash Rehabilitation Medicine Unit, Epworth HealthCare, Melbourne, Australia
| | - Emma Dean
- Population Health, Alfred Health, Melbourne, Australia.,Quit, Cancer Council Victoria, Melbourne, Australia
| | - Gemma Smoker
- Population Health, Alfred Health, Melbourne, Australia
| | - Martyn Lloyd-Jones
- Department of Mental and Addiction Health, Alfred Hospital, Melbourne, Australia
| | - Megan McKechnie
- Department of Mental and Addiction Health, Alfred Hospital, Melbourne, Australia
| | - Paul M Dietze
- Program for Behaviours and Health Risks, Burnet Institute, Melbourne, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.,National Drug Research Institute, Curtin University, Melbourne, Australia
| | - Joseph S Doyle
- Program for Disease Elimination, Burnet Institute, Melbourne, Australia.,Department of Infectious Diseases, Alfred Health and Monash University, Melbourne, Australia
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