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Effectiveness of community psychosocial and pharmacological treatments for alcohol use disorder: a national observational cohort study in England

Citation

Peacock, A and Eastwood, B and Jones, A and Millar, T and Horgan, P and Knight, J and Randhawa, K and White, M and Marsden, J, Effectiveness of community psychosocial and pharmacological treatments for alcohol use disorder: a national observational cohort study in England, Drug and Alcohol Dependence, 186 pp. 60-67. ISSN 0376-8716 (2018) [Refereed Article]

Copyright Statement

© 2018 Elsevier B.V. All rights reserved.

DOI: doi:10.1016/j.drugalcdep.2018.01.019

Abstract

Background: This was a national English observational cohort study using administrative data to estimate the effectiveness of community pharmacological and psychosocial treatment for alcohol use disorder (AUD).

Methods: All adults commencing AUD treatment in the community reported to the National Drug Treatment Monitoring System (April 1 2014–March 31 2015; N = 52,499). Past 28-day admission drinking pattern included drinks per drinking day (DDD): 0 (‘Abstinent’), 1–15 (‘Low-High’), 16–30 (‘High-Extreme’) and over 30 DDD (‘Extreme’). The primary outcome was successful completion of treatment within 12 months of commencement with no re-presentation (SCNR) in the subsequent six months, analysed by multi-level, mixed effects, multivariable logistic regression.

Results: The majority reported DDD in the ‘Low-High’ (n = 17,698, 34%) and ‘High-Extreme’ (n = 21,383, 41%) range. Smaller proportions were categorised ‘Extreme’ (n = 7759, 15%) and ‘Abstinent’ (n = 5661, 11%). Three-fifths (58%) achieved SCNR. Predictors of SCNR were older age, black/minority ethnic group, employment, criminal justice system referral, and longer treatment exposure. Predictors of negative outcome were AUD treatment history, lower socio-economic status, housing problems, and ‘Extreme’ drinking at admission. In addition to psychosocial interventions, pharmacological interventions and recovery support increased the likelihood of SCNR. Pharmacological treatment was only beneficial for the ‘Low-High’ groups with recovery support.

Conclusions: Over half of all patients admitted for community AUD treatment in England are reported to successfully complete treatment within 12 months and are not re-admitted for further treatment in the following 6 months. Study findings underscore efforts to tailor AUD treatment to the severity of alcohol consumption and using recovery support.

Item Details

Item Type:Refereed Article
Keywords:treatment, alcohol use disorder, psychosocial, pharmacological, recovery
Research Division:Psychology and Cognitive Sciences
Research Group:Psychology
Research Field:Biological Psychology (Neuropsychology, Psychopharmacology, Physiological Psychology)
Objective Division:Health
Objective Group:Public Health (excl. Specific Population Health)
Objective Field:Substance Abuse
UTAS Author:Peacock, A (Miss Amy Peacock)
ID Code:130901
Year Published:2018
Deposited By:Psychology
Deposited On:2019-02-19
Last Modified:2019-04-15
Downloads:0

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