The Place of Pharmacotherapy in Alcohol Use Disorder Management in Family Practice - A Systematic Review

2020 ◽  
Vol 26 ◽  
Author(s):  
Guillou Landreat Morgane ◽  
Le Goff Delphine ◽  
Kergoat Guillaume ◽  
Le Reste Jean Yves
Keyword(s):  
Primary Care ◽  
Alcohol Use ◽  
Literature Review ◽  
Systematic Literature Review ◽  
English Language ◽  
Alcohol Use Disorders ◽  
Care Practice ◽  
Prescription Database ◽  
Cross Sectional ◽  
Care Guidelines

Background and aims: Alcohol use disorders (AUD) are among the most prevalent mental disorders around the world, yet still remain the most undertreated. Many studies report the low rate of treatment uptake, less than 20%, among people with AUD. Among those accessing care, a large majority only approach their GP for help. Therefore, primary care is a strategic setting for the identification and the management of AUD. International recommendations stress AUD pharmacotherapy for withdrawal and craving management, but very few studies have shown interest in the management of AUDs in primary care. The main objective of this study was to analyse pharmacotherapy in AUD management in primary care by means of a systematic literature review. Methods: A systematic literature review (PRISMA), was carried out. 5 databases were screened: PUBMED via MEDLINE, LiSSa, the SUDOC catalogue, PASCAL and EMBASE. Search algorithms were used integrating the concepts of pharmacotherapy management, alcohol use disorders and primary care, only in English language. Results: 296 studies were selected and 10 were included. One is a follow-up study on the national prescription database, four were cross-sectional studies with an auto-questionnaire survey . Of the 10 studies included, two were conducted in Europe , five in North America, two in Australia and one in South Africa. These pharmacotherapy studies were concerned with anti-craving treatment, and 3 types of medication were used : disulfiram, acamprosate and naltrexone. Factors identified as limiting or facilitating prescriptions concerned cost, indications, efficacy, training and adjuncts to pharmacotherapy. Conclusion: Knowledge and prescription of pharmacotherapy for AUD, more specifically anti-craving treatment, is insufficient in primary care. There is a lack of data and studies on the efficacy of anti-craving treatment in primary care. Guidelines for AUD management, including psychological and medical management and pharmacotherapy do exist, but have not been adapted to primary care practice. Barriers and facilitators of pharmacotherapy prescription in AUD in primary care were identified in this study.

Medications for Alcohol Use Disorders in a Primary Care Practice-Based Research Network Implementation Study

2014 ◽  
Vol 32 (1) ◽  
pp. 58-66
Author(s):  
Andrea M. Wessell ◽  
Lynne S. Nemeth ◽  
Ruth G. Jenkins ◽  
Steven M. Ornstein ◽  
Peter M. Miller
Keyword(s):  
Primary Care ◽  
Alcohol Use ◽  
Primary Care Practice ◽  
Alcohol Use Disorders ◽  
Research Network ◽  
Care Practice ◽  
Implementation Study ◽  
Practice Based Research

scholarly journals Completeness and validity of alcohol recording in general practice within the UK: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031537
Author(s):  
Kathryn Mansfield ◽  
Elizabeth Crellin ◽  
Rachel Denholm ◽  
Jennifer K Quint ◽  
Liam Smeeth ◽  
...  
Keyword(s):  
Primary Care ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Gold Standard ◽  
Alcohol Use Disorders ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Consumption Data ◽  
The Uk

BackgroundSince 2010 the National Institute for Health and Care Excellence has recommended screening adults for excessive alcohol consumption to try and help prevent alcohol-use disorders. Little is known about the extent to which these recommendations are followed, and the resulting completeness and validity of alcohol-related data recording in primary care.ObjectiveTo investigate the completeness and accuracy of recording of alcohol use within primary care records in the UK.Design and settingCross-sectional study in the Clinical Practice Research Datalink.ParticipantsWe included all adult patients registered on 1st January 2018 with ≥1 year of follow-up.Primary and secondary outcome measuresWe calculated prevalence of alcohol consumption recording overall and within patient groups. We then validated alcohol consumption data against recommended screening tools (Alcohol Use Disorders Identification Test (AUDIT)) as the gold standard. We also calculated how prevalence of alcohol recording changed over the preceding decade.ResultsIn 2018, among 1.8 million registered adult patients, just over half (51.9%) had a record for a code related to alcohol in the previous 5 years. Recording of alcohol consumption was more common among women, older people, ex-smokers and those from more deprived areas, who were overweight/obese, or with comorbidities. A quarter of patients had units per week recorded in the last 5 years, but <10% had an AUDIT or Fast Alcohol Screening Test (FAST) alcohol screening test score. The recorded alcohol measures corresponded to results from gold standard AUDIT scores. The distribution of consumption among current drinkers was similar to the Health Survey for England.ConclusionsHalf of adults in UK primary care have no recorded alcohol consumption data. When consumption is recorded, we have demonstrated internal and external validity of the data, suggesting greater recording may help identify opportunities for interventions to reduce harms.

scholarly journals AB0747 MATERNAL AND FETAL OUTCOMES IN PREGNANT WOMEN WITH JUVENILE IDIOPATHIC ARTHRITIS: A SYSTEMATIC LITERATURE REVIEW

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1402.1-1402
Author(s):  
R. Pinheiro Torres ◽  
M. H. Fernandes Lourenco ◽  
A. Neto ◽  
F. Pimentel Dos Santos ◽  
I. Silva ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Literature Review ◽  
Pregnant Women ◽  
Systematic Literature Review ◽  
English Language ◽  
Placenta Previa ◽  
Bibliographic Databases ◽  
Fetal Outcomes ◽  
Term Birth ◽  
Increased Risk

Background:Juvenile idiopathic arthritis (JIA), one of the most common chronic diseases in children, can be classified in seven different categories according to its onset presentation. Concerns about pregnancy outcomes play a secondary role in disease approach. However, recent data showed an increased risk of pre-term birth in women with JIA instead the small patient samples analysed.Objectives:In this review, our aim is to describe the current available knowledge on JIA adverse, maternal and fetal, outcomes.Methods:A systematic literature review was conducted since January of 2000 until December 2020, by searching the PubMed and Embase bibliographic databases. The search was limited to articles in English language, presenting a comparator group (healthy individuals or patients without known auto-immune rheumatic diseases) and at least one clinical outcome of interest. Two independent reviewers screened the titles and abstracts followed by a full-text review to assess papers regarding their eligibility.Results:Ten observational studies out of 1560 references, fulfilled the inclusion criteria, of which, 9 were retrospective and 1 prospective. A total of 6.214 women with JIA (with 6.811 pregnancies) and 18.659.513 healthy controls (with 21.339.194 pregnancies) were included in this review.Concerning maternal outcomes, delivery by caesarian section (CS) was more frequent among JIA women (in 4 out of 6 studies). Pre-eclampsia was referred in 3 out of 6 studies and a higher risk of vaginal bleeding and placenta previa in one additional study. No study found an increased risk for gestational diabetes or hypertension in pregnant women with JIA.Regarding fetal outcomes, 8 studies revealed significantly increased of pre-term birth (only in first births in one study) but one study didn’t show any increased risk. Two studies showed a higher risk of small gestational age (SGA) and in another 2, increased risk for low birth weight (LBW). No evidence of increased risk of major congenital malformations.Conclusion:This systematic review suggests an increased risk for pre-eclampsia, preterm birth, delivery by CS, SGA and LBW, among pregnant women with JIA. Conclusions should be carefully interpreted, giving the heterogeneity of studied populations regarding demography, disease type, disease activity, and prescribed medication.Disclosure of Interests:None declared

scholarly journals Cross-sectional study evaluating the association between integrated care and health-related quality of life (HRQOL) in Dutch primary care

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e040781
Author(s):  
Pim P Valentijn ◽  
Marcel Kerkhoven ◽  
Jantien Heideman ◽  
Rosa Arends
Keyword(s):  
Primary Care ◽  
Integrated Care ◽  
Primary Care Practice ◽  
Anxiety And Depression ◽  
Care Practice ◽  
Cross Sectional ◽  
Practice Population ◽  
Related Quality ◽  
Health Related

ObjectivesThe aim of this study was to evaluate the association between integrated care and health-related quality of life (HRQOL) in a primary care practice population.DesignA cross-sectional survey study.SettingPrimary care practice population.ParticipantsA sample (n=5562) of patients in two general practitioner practices in the Netherlands.Primary outcome measuresThe Rainbow Model of Integrated Care Measurement Tool patient version and EQ-5D was used to assess integrated service delivery and HRQOL. The association between integrated care and HRQOL groups was analysed using multivariate logistic regression.ResultsOverall, 933 respondents with a mean age of 62 participated (20% response rate) in this study. The multivariate analysis revealed that positive organisational coordination experiences were linked to better HRQOL (OR=1.87, 95% CI 1.18 to 2.95), and less anxiety and depression problems (OR=0.36, 95% CI 0.20 to 0.63). Unemployment was associated with a poor HRQOL (OR=0.15, 95% CI 0.08 to 0.28). Ageing was associated with more mobility (OR=1.06, 95% CI 1.04 to 1.09), self-care (OR=1.06, 95% CI 1.02 to 1.11), usual activity (OR=1.03, 95% CI 1.01 to 1.05) and pain problems (OR=1.02, 95% CI 1.01 to 1.04). Being married improved the overall HRQOL (OR=1.60, 95% CI 1.13 to 2.26) and decreased anxiety and depression (OR=0.47, 95% CI 0.31 to 0.72). Finally, females had a poor overall HRQOL (OR=1.67, 95% CI 0.48 to 0.93) and more pain and discomfort problems (OR=1.47, 95% CI 1.11 to 1.95).ConclusionThis study shows for the first time that organisational coordination activities are positively associated with HROQL of adult patients in a primary care context, adding to the evidence of an association between integrated care and HRQOL. Also, unemployment, ageing and being female are accumulating risk factors that should be considered when designing integrated primary care programmes. Further research is needed to explore how various integration types relate to HRQOL for people in local communities.

scholarly journals Assessment of alcohol use disorder and its associated factors among alcohol users of medical and surgical outpatients attending a specialized hospital in Gondar, Ethiopia: a cross-sectional study

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Demeke Demilew ◽  
Berhanu Boru ◽  
Getachew Tesfaw ◽  
Habtamu Kerebih ◽  
Endalamaw Salelew
Keyword(s):  
Alcohol Use ◽  
Associated Factors ◽  
Alcohol Use Disorder ◽  
Alcohol Use Disorders ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Multivariate Logistic Regression ◽  
Cross Sectional ◽  
History Of ◽  
Male Sex

Abstract Background Alcohol use disorder increase the risk of physical harm, mental or social consequences for patients and others in the community. Studies on alcohol use disorder and associated factors among medical and surgical outpatients in Ethiopia are limited. Therefore, this study is meant to provide essential data on alcohol use disorder and associated factors among alcohol user medical and surgical outpatients to intervene in the future. Methods An institution-based cross-sectional study was conducted by using the systematic random sampling technique. Alcohol use disorders were assessed using the World Health Organization’s 10-item Alcohol Use Disorder Identification Test (AUDIT) questionnaire. Bivariate and multivariate logistic regression analyses were performed, a P-value less than 0.05 were considered statistically significant in the multivariate analysis and the strength of association was measured at a 95% confidence interval. Results The prevalence of alcohol use disorder was 34.5% with a 95% CI (29.20, 39.80) among study participants. In the multivariate logistic regression analysis, male sex (AOR = 3.33, 95%CI: 1.40, 7.93), history of mental illness (AOR = 2.68, 95%CI: 1.12, 6.38), drinking for relaxation (AOR = 1.88, 95%CI: 1.02, 3.48) and history of lifetime tobacco use (AOR = 5.64, 95%CI: 1.95, 16.29) were factors significantly associated with alcohol use disorder. Conclusion The prevalence of alcohol use disorders among medical and surgical outpatients was found to be high. Male sex, history of mental illness, alcohol use for relaxation and lifetime cigarette smoking need more attention during the assessment of patients in the medical and surgical outpatient departments.

scholarly journals The development of urban community health centres for strengthening primary care in China: a systematic literature review

2015 ◽  
pp. ldv043 ◽  
Author(s):  
Harry H. X. Wang ◽  
Jia Ji Wang ◽  
Samuel Y. S. Wong ◽  
Martin C. S. Wong ◽  
Stewart W. Mercer ◽  
...  
Keyword(s):  
Primary Care ◽  
Literature Review ◽  
Community Health ◽  
Systematic Literature Review ◽  
Urban Community ◽  
Community Health Centres ◽  
Health Centres

scholarly journals Collaborative Care for Opioid and Alcohol Use Disorders in Primary Care

2017 ◽  
Vol 177 (10) ◽  
pp. 1480 ◽  
Author(s):  
Katherine E. Watkins ◽  
Allison J. Ober ◽  
Karen Lamp ◽  
Mimi Lind ◽  
Claude Setodji ◽  
...  
Keyword(s):  
Primary Care ◽  
Alcohol Use ◽  
Collaborative Care ◽  
Alcohol Use Disorders

Monoallelic KIF1A-related disorders: a multicenter cross sectional study and systematic literature review

2021 ◽  
Author(s):  
Stefania Della Vecchia ◽  
Alessandra Tessa ◽  
Claudia Dosi ◽  
Jacopo Baldacci ◽  
Rosa Pasquariello ◽  
...  
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Homicides and socio-environmental determinants of health in Brazil: a systematic literature review

2018 ◽  
Vol 34 (12) ◽  
Author(s):  
Clovis Wanzinack ◽  
Marcos Claudio Signorelli ◽  
Clóvis Reis
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Protective Factor ◽  
Social Inequalities ◽  
Determinants Of Health ◽  
Environmental Determinants ◽  
Development Education ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Environmental Determinants Of Health

Abstract: Brazil currently has the highest absolute number of homicides in the world, which results from a complex range of factors. This study aimed at understanding the associations between socio-environmental determinants of health (SDH) and homicides in Brazil through a systematic literature review. The review followed PRISMA guidelines, selecting quantitative and qualitative studies published in Portuguese, English, and Spanish carried out between 2002 and 2017, available in the PubMed, MEDLINE, LILACS, SciELO and BVS-BIREME databases. Two trilingual reviewers tracked studies independently by basing on the eligibility criteria. We critically assessed the selected studies with the Critical Appraisal Skills Programme (CASP) or the Checklist for Analytical Cross-Sectional Studies, depending on the study design. We considered 60 studies and grouped their SDH into categories to develop a narrative synthesis about each SDH. These categories were: territory; race/ethnicity; gender; age; social inequalities and economic factors; development; education; work and employment; drugs and trafficking; other SDH. We found some SDH were more associated with homicides, such as being young, black, male, of low education level, and also people who lived in places of high social inequality, such as urban suburbs and agricultural frontiers. Unemployment and drug trafficking, as well as intersections between various SDH were also prominent. Education seems to be a protective factor for homicide. Despite the limited capacity of interpretation due to the high range of methodological approaches, this review shows the importance of considering SDH and their intersections when developing homicide prevention policies.

scholarly journals A Cross-Sectional Comparison of Drinking Patterns, Alcohol Use and Related Medical Morbidities in a Secondary Versus Tertiary Setting

2015 ◽  
Vol 11 (2) ◽  
pp. 152-157
Author(s):  
A Risal ◽  
H Tharoor
Keyword(s):  
Alcohol Use ◽  
Alcohol Dependence ◽  
Tertiary Care ◽  
Alcohol Use Disorders ◽  
Care Utilization ◽  
Drinking Patterns ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Patterns Of Drinking ◽  
Level Hospital

Background Alcohol Dependence exists in different spectrums at different settings and associated with various medical morbidities, disability and health care utilization costs. Objectives To study the drinking patterns, alcohol use disorders and alcohol related medical morbidities in patients diagnosed with Alcohol Dependence Syndrome (ADS) and attending out / in-patient psychiatry services at secondary and tertiary care centre. Methods A cross-sectional comparative study was done among the patients diagnosed with ADS attending psychiatry services at District hospital, Udupi and Kasturba Hospital, Manipal. Serial sampling was done. Patients having any other psychiatric illnesses were excluded. The two groups were compared in relation to socio-demographic variables, drinking related variables, patterns of drinking and alcohol related medical morbidities identified. Results Significant differences in some socio-demographic parameters among the patients from the two different treatment centers were found with secondary level hospital (N=50) having more illiterate, laborers and below the poverty line population in comparison to the tertiary level hospital (N=75). Maximum frequency of gastro-intestinal morbidities was seen in both the hospital population, irrespective of the patterns of drinking. Conclusion Alcohol use disorders and alcohol related medical morbidities show some variations in their presentations in the different treatment centers. DOI: http://dx.doi.org/10.3126/kumj.v11i2.12492 Kathmandu University Medical Journal Vol.11(2) 2013: 152-157

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