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Disparities in pharmacotherapy for alcohol use disorder in the context of universal health care: a Swedish register study.

https://arctichealth.org/en/permalink/ahliterature289476
Source
Addiction. 2017 Aug; 112(8):1386-1394
Publication Type
Journal Article
Date
Aug-2017
Author
Katherine J Karriker-Jaffe
Jianguang Ji
Jan Sundquist
Kenneth S Kendler
Kristina Sundquist
Author Affiliation
Alcohol Research Group, Public Health Institute, Emeryville, CA, USA.
Source
Addiction. 2017 Aug; 112(8):1386-1394
Date
Aug-2017
Language
English
Publication Type
Journal Article
Keywords
Adult
Alcohol Deterrents - therapeutic use
Alcoholism - drug therapy
Cohort Studies
Drug Prescriptions - statistics & numerical data
Female
Healthcare Disparities - statistics & numerical data
Humans
Male
Middle Aged
Poverty
Registries - statistics & numerical data
Residence Characteristics
Risk factors
Socioeconomic Factors
Sweden
Universal Coverage
Abstract
Pharmacotherapy can be an important part of the continuum of care for alcohol use disorder (AUD). The Swedish universal health-care system emphasizes provision of care to marginalized groups. The primary aim was to test associations of neighborhood deprivation and disadvantaged social status with receipt of AUD pharmacotherapy in this context.
Data from linked population registers were used to follow an open cohort over 7 years.
Sweden.
Alcohol-related ICD-10 codes reported for all hospitalizations in the Swedish Hospital Discharge Register and all clinic/office visits in the Outpatient Care Register between 2005 and 2012 were used to identify 62?549 cases with AUD.
The primary outcome was any AUD pharmacotherapy (naltrexone, disulfiram, acamprosate, nalmefene) picked up by patients between 2005 and 2012 (versus none), based on the Swedish Prescribed Drug Register. Neighborhood deprivation was defined using aggregated data from the Total Population Register; indicators of disadvantaged social status (income, education, country of origin) also came from this source.
Approximately half the cases (53.7%) picked up one or more AUD pharmacotherapy prescriptions. In adjusted models, people living in neighborhoods with moderate [odds ratio (OR) = 0.90, 95% confidence interval (CI) = 0.86, 0.95] or high levels of deprivation (OR = 0.75, 95% CI = 0.70, 0.79) compared with low deprivation, those with lower incomes (for example, lowest quartile: OR = 0.70, 95% CI = 0.66, 0.73 compared with highest) and less education (for example,
Notes
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Cites: Drug Alcohol Depend. 2003 Sep 10;71(3):281-94 PMID 12957346
Cites: Alcohol Clin Exp Res. 2004 Aug;28(8):1229-35 PMID 15318122
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Cites: Health Place. 2013 Sep;23:63-9 PMID 23771166
Cites: J Psychiatr Res. 2015 Jul-Aug;66-67:7-15 PMID 25953099
Cites: J Epidemiol Community Health. 2004 Jan;58(1):71-7 PMID 14684730
Cites: Drug Alcohol Depend. 2016 Jul 1;164:135-42 PMID 27234657
Cites: Diabetes Care. 2012 Nov;35(11):2257-64 PMID 22891257
Cites: Addiction. 2008 Nov;103(11):1801-8 PMID 19032530
Cites: J Psychiatr Res. 2015 Oct;69:150-7 PMID 26343607
Cites: Am J Epidemiol. 2004 Apr 1;159(7):655-62 PMID 15033643
Cites: Alcohol Alcohol. 2016 May;51(3):307-14 PMID 26433947
Cites: Expert Rev Pharmacoecon Outcomes Res. 2005 Apr;5(2):205-14 PMID 19807575
PubMed ID
28406579 View in PubMed
Less detail

Disparities in pharmacotherapy for alcohol use disorder in the context of universal health care: a Swedish register study.

https://arctichealth.org/en/permalink/ahliterature289634
Source
Addiction. 2017 Aug; 112(8):1386-1394
Publication Type
Journal Article
Date
Aug-2017
Author
Katherine J Karriker-Jaffe
Jianguang Ji
Jan Sundquist
Kenneth S Kendler
Kristina Sundquist
Author Affiliation
Alcohol Research Group, Public Health Institute, Emeryville, CA, USA.
Source
Addiction. 2017 Aug; 112(8):1386-1394
Date
Aug-2017
Language
English
Publication Type
Journal Article
Keywords
Adult
Alcohol Deterrents - therapeutic use
Alcoholism - drug therapy
Cohort Studies
Drug Prescriptions - statistics & numerical data
Female
Healthcare Disparities - statistics & numerical data
Humans
Male
Middle Aged
Poverty
Registries - statistics & numerical data
Residence Characteristics
Risk factors
Socioeconomic Factors
Sweden
Universal Coverage
Abstract
Pharmacotherapy can be an important part of the continuum of care for alcohol use disorder (AUD). The Swedish universal health-care system emphasizes provision of care to marginalized groups. The primary aim was to test associations of neighborhood deprivation and disadvantaged social status with receipt of AUD pharmacotherapy in this context.
Data from linked population registers were used to follow an open cohort over 7 years.
Sweden.
Alcohol-related ICD-10 codes reported for all hospitalizations in the Swedish Hospital Discharge Register and all clinic/office visits in the Outpatient Care Register between 2005 and 2012 were used to identify 62?549 cases with AUD.
The primary outcome was any AUD pharmacotherapy (naltrexone, disulfiram, acamprosate, nalmefene) picked up by patients between 2005 and 2012 (versus none), based on the Swedish Prescribed Drug Register. Neighborhood deprivation was defined using aggregated data from the Total Population Register; indicators of disadvantaged social status (income, education, country of origin) also came from this source.
Approximately half the cases (53.7%) picked up one or more AUD pharmacotherapy prescriptions. In adjusted models, people living in neighborhoods with moderate [odds ratio (OR) = 0.90, 95% confidence interval (CI) = 0.86, 0.95] or high levels of deprivation (OR = 0.75, 95% CI = 0.70, 0.79) compared with low deprivation, those with lower incomes (for example, lowest quartile: OR = 0.70, 95% CI = 0.66, 0.73 compared with highest) and less education (for example,
Notes
Cites: Med Care. 2002 Jan;40(1):52-9 PMID 11748426
Cites: Drug Alcohol Depend. 2003 Sep 10;71(3):281-94 PMID 12957346
Cites: Alcohol Clin Exp Res. 2004 Aug;28(8):1229-35 PMID 15318122
Cites: Psychiatr Serv. 2004 Mar;55(3):221 PMID 15001719
Cites: Curr Psychiatry Rep. 2011 Oct;13(5):374-81 PMID 21773951
Cites: J Addict Med. 2011 Mar;5(1):21-7 PMID 21359109
Cites: Drug Alcohol Depend. 2016 Sep 1;166:254-7 PMID 27394934
Cites: J Acquir Immune Defic Syndr. 2008 Sep 1;49(1):84-93 PMID 18667919
Cites: Subst Use Misuse. 2006;41(3):283-96 PMID 16467006
Cites: J Stud Alcohol Drugs Suppl. 2014;75 Suppl 17:79-88 PMID 24565314
Cites: Eval Program Plann. 2011 Nov;34(4):375-81 PMID 21371752
Cites: Health Place. 2011 Mar;17(2):551-7 PMID 21239211
Cites: BMC Public Health. 2013 May 20;13:488 PMID 23688340
Cites: Am J Prev Med. 2007 Feb;32(2):97-106 PMID 17234484
Cites: Addiction. 2002 Mar;97(3):249-52 PMID 11964098
Cites: Biomed Res Int. 2015;2015:137020 PMID 25629034
Cites: Subst Use Misuse. 2014 Nov;49(13):1764-73 PMID 24963556
Cites: Ann N Y Acad Sci. 2014 Oct;1327:112-30 PMID 25236185
Cites: Soc Work Public Health. 2013;28(3-4):388-406 PMID 23731427
Cites: J Psychoactive Drugs. 2010 Sep;Suppl 6:227-38 PMID 21138199
Cites: Drug Alcohol Depend. 2003 Sep 10;71(3):219-28 PMID 12957340
Cites: Health Place. 2011 Jan;17(1):132-9 PMID 20961797
Cites: Addiction. 2004 Nov;99(11):1382-92 PMID 15500591
Cites: Am J Addict. 2003 Jul-Sep;12(4):281-94 PMID 14504021
Cites: Psychol Med. 2014 Sep;44(12):2537-46 PMID 25055172
Cites: Can J Psychiatry. 2014 Dec;59(12):624-31 PMID 25702361
Cites: Am J Epidemiol. 2005 Jul 15;162(2):171-82 PMID 15972939
Cites: Health Place. 2013 Sep;23:63-9 PMID 23771166
Cites: J Psychiatr Res. 2015 Jul-Aug;66-67:7-15 PMID 25953099
Cites: J Epidemiol Community Health. 2004 Jan;58(1):71-7 PMID 14684730
Cites: Drug Alcohol Depend. 2016 Jul 1;164:135-42 PMID 27234657
Cites: Diabetes Care. 2012 Nov;35(11):2257-64 PMID 22891257
Cites: Addiction. 2008 Nov;103(11):1801-8 PMID 19032530
Cites: J Psychiatr Res. 2015 Oct;69:150-7 PMID 26343607
Cites: Am J Epidemiol. 2004 Apr 1;159(7):655-62 PMID 15033643
Cites: Alcohol Alcohol. 2016 May;51(3):307-14 PMID 26433947
Cites: Expert Rev Pharmacoecon Outcomes Res. 2005 Apr;5(2):205-14 PMID 19807575
PubMed ID
28406579 View in PubMed
Less detail

Effectiveness of alcohol treatment interventions integrated into routine tuberculosis care in Tomsk, Russia.

https://arctichealth.org/en/permalink/ahliterature115578
Source
Addiction. 2013 Aug;108(8):1387-96
Publication Type
Article
Date
Aug-2013
Author
Sonya Shin
Viktoria Livchits
Hilary Smith Connery
Alan Shields
Sergei Yanov
Galina Yanova
Garrett M Fitzmaurice
Adrianne K Nelson
Shelly F Greenfield
Author Affiliation
Harvard Medical School, Brigham and Women’s Hospital, Division of Global Health Equity, 75 Francis Street, Boston, MA 02115, USA. sshin@partners.org
Source
Addiction. 2013 Aug;108(8):1387-96
Date
Aug-2013
Language
English
Publication Type
Article
Keywords
Adult
Alcohol Abstinence
Alcohol Deterrents - therapeutic use
Alcoholism - complications - prevention & control
Behavior Therapy - methods
Combined Modality Therapy
Counseling
Feasibility Studies
Female
Humans
Male
Naltrexone - therapeutic use
Patient compliance
Russia
Treatment Outcome
Tuberculosis - complications - therapy
Abstract
To test the feasibility and effectiveness of brief counseling intervention (BCI) and naltrexone integrated into tuberculosis (TB) care in Tomsk, Russia.
Using a factorial randomized controlled trial design, patients were randomized into: naltrexone (NTX), brief behavioral compliance enhancement therapy (BBCET), treatment as usual (TAU) and BCI.
In the Tomsk Oblast, hospitalized TB patients diagnosed with alcohol use disorders (AUDs) by the DSM-IV were referred at the start of TB treatment. Of the 196 participants, the mean age was 41 years and 82% were male. Severe TB (84.7% had cavitary disease) and smoking (92.9%) were common. The majority had a diagnosis of an AUD (63.0%); 27.6% reported nearly daily drinking and consumed a median of 16 standard drinks per day.
Primary outcomes were 'favorable' TB outcome (cured, completed treatment) and change in mean number of abstinent days in the last month of study compared with baseline. Change in mean number of heavy drinking days, defined as four drinks per day and five drinks per day for women and men, respectively, and TB adherence, measured as percentage of doses taken as prescribed under direct observation, were secondary outcomes. Analysis based on 'intention-to-treat' was performed for multivariable analysis.
Primary TB and alcohol end-points between naltrexone and no-naltrexone or BCI and no-BCI groups did not differ significantly. TB treatment adherence and change in number of heavy drinking days also did not differ significantly among treatment arms. Among individuals with a prior quitting attempt (n?=?111), naltrexone use was associated with an increased likelihood of favorable TB outcomes (92.3% versus 75.9%, P?=?0.02).
In Tomsk Oblast, Russia, tuberculosis patients with severe alcohol use disorders who were not seeking alcohol treatment did not respond to naltrexone or behavioral counselling integrated into tuberculosis care; however, those patients with past attempts to quit drinking had improved tuberculosis outcomes.
Notes
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PubMed ID
23490304 View in PubMed
Less detail

[The effect of medikhronal on the biogenic amine level in the brain structures and blood of animals with alcohol dependence]

https://arctichealth.org/en/permalink/ahliterature10622
Source
Fiziol Zh. 1999;45(4):111-9
Publication Type
Article
Date
1999
Author
N K Kharchenko
Author Affiliation
Ukrainian Scientific-Research Institute of Social and Forensic Psychiatry, Ministry of Public Health of Ukraine, Kiev.
Source
Fiziol Zh. 1999;45(4):111-9
Date
1999
Language
Ukrainian
Publication Type
Article
Keywords
Alcohol Deterrents - therapeutic use
Alcoholic Intoxication - drug therapy - metabolism
Alcoholism - drug therapy - metabolism
Animals
Biogenic Amines - metabolism
Brain - drug effects - metabolism
Brain Chemistry - drug effects
Comparative Study
Drug Combinations
Drug Evaluation, Preclinical
English Abstract
Formates - therapeutic use
Glucose - therapeutic use
Glycine - therapeutic use
Male
Rats
Time Factors
Abstract
Peculiarities of changes in the content of biogenic amines in the brain structures (hypothalamus, midbrain and new cortex) and blood of rats under alcohol intoxication and formation of alcohol dependence were investigated, and the effect of medichronal and its components on the mentioned processes was found out. It has been established that accumulation of acetaldehide plays a considerable role in the mechanism of formation of alcohol dependence. Changes in the level of ethanol (E) and AcA in blood after the arrival of exogenic E to the organism evokes phase dynamics of content of biogenic amines in the blood and brain sections. Medichronal components, binding and inactivating AcA, as well as taking the mutually supplementing effect on synthesis of biogenic amines, promote normalization of the mentioned processes and elimination of alcohol dependence.
PubMed ID
10474811 View in PubMed
Less detail

Treatment received by alcohol-dependent suicide attempters.

https://arctichealth.org/en/permalink/ahliterature202560
Source
Acta Psychiatr Scand. 1999 Mar;99(3):214-9
Publication Type
Article
Date
Mar-1999
Author
K H Suominen
E T Isometsä
M M Henriksson
A I Ostamo
J K Lönnqvist
Author Affiliation
Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland.
Source
Acta Psychiatr Scand. 1999 Mar;99(3):214-9
Date
Mar-1999
Language
English
Publication Type
Article
Keywords
Adult
Alcohol Deterrents - therapeutic use
Alcoholism - diagnosis - psychology - rehabilitation
Disulfiram - therapeutic use
Female
Finland
Follow-Up Studies
Humans
Male
Medical Records
Psychiatric Status Rating Scales
Psychotherapy - methods
Retrospective Studies
Suicide, Attempted - prevention & control
World Health Organization
Abstract
The purpose of this study was to examine the clinical features of alcohol-dependent suicide attempters and the treatment they received before and after the index attempt. A total of 47 subjects with current DSM-III-R alcohol dependence were identified from a systematic sample of 114 suicide attempters in Helsinki. All of them were comprehensively interviewed after the attempt, and the treatment they had received was established from psychiatric and other health-care records and follow-up interviews. Most had a history of psychiatric (83%) or substance abuse (83%) treatment. During the final month before the attempt, half of the subjects (51%) had been treated by health care services; 11% had received disulfiram-treatment and 6% had received psychotherapy. Subjects complied with recommended aftercare more often when they had been actively referred. After 1 month, 64% were being treated by health care services. However, only 14% were receiving disulfiram-treatment and 9% were receiving psychotherapy. These findings suggest that the quality and activity of treatment offered to suicide attempters with alcohol dependence should be improved.
PubMed ID
10100916 View in PubMed
Less detail

Use of disulfiram and risk of cancer: a population-based case-control study.

https://arctichealth.org/en/permalink/ahliterature259762
Source
Eur J Cancer Prev. 2014 May;23(3):225-32
Publication Type
Article
Date
May-2014
Author
Gro Askgaard
Søren Friis
Jesper Hallas
Lau C Thygesen
Anton Pottegård
Source
Eur J Cancer Prev. 2014 May;23(3):225-32
Date
May-2014
Language
English
Publication Type
Article
Keywords
Aged
Alcohol Deterrents - therapeutic use
Breast Neoplasms - epidemiology
Case-Control Studies
Denmark - epidemiology
Disulfiram - therapeutic use
Female
Humans
Male
Melanoma - epidemiology
Middle Aged
Neoplasms - epidemiology - etiology
Prostatic Neoplasms - epidemiology
Registries
Risk factors
Abstract
Experimental studies have indicated that disulfiram (Antabuse) has antineoplastic effects against melanoma, breast, and prostate cancer. To explore this hypothesis, we examined the association between disulfiram use and these cancers in a nationwide register-based case-control study nested within ever-users (=one prescription) of disulfiram. Cases were all Danish individuals with a histologically verified first-time diagnosis of malignant melanoma, breast, or prostate cancer during 2000-2009. For each case, we selected four cancer-free controls matched for age, sex, and year of first disulfiram prescription using risk set sampling. Similarly, for secondary analyses, we selected case-control populations for selected tobacco-related and alcohol-related cancer types, that is, cancers of the buccal cavity, liver, lung, and colorectal cancer. Disulfiram use 1 year before cancer diagnosis and the corresponding date for controls were disregarded. We estimated crude and adjusted odds ratios and 95% confidence intervals (CI) for cancer associated with long-term (=500 daily defined doses) versus one-time (one prescription) use of disulfiram. Among 53 856 disulfiram users, we identified 166, 644, and 464 cases, respectively, of melanoma, breast, or prostate cancer. Adjusted odds ratios for melanoma, breast, or prostate cancer associated with long-term disulfiram use were 1.04 (95% CI: 0.60-1.78), 0.92 (95% CI: 0.70-1.22), and 0.77 (95% CI: 0.56-1.06), respectively. For prostate cancer, dose-response analyses showed a further risk reduction with the highest cumulative dose level of disulfiram; however, the test for trend did not reach statistical significance. Our study provides some epidemiological support for a protective effect of disulfiram against prostate and breast cancer.
PubMed ID
23863824 View in PubMed
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7 records – page 1 of 1.