scholarly journals The Kaiser Permanente Northern California Adult Alcohol Registry, an Electronic Health Records-Based Registry of Patients With Alcohol Problems: Development and Implementation

10.2196/19081 ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. e19081
Author(s):  
Vanessa A Palzes ◽  
Constance Weisner ◽  
Felicia W Chi ◽  
Andrea H Kline-Simon ◽  
Derek D Satre ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Health System ◽  
Health Problem ◽  
Alcohol Problems ◽  
Adult Patients ◽  
Northern California ◽  
Inclusion Criteria ◽  
Kaiser Permanente ◽  
Unhealthy Alcohol Use ◽  
Unhealthy Alcohol

Background Electronic health record (EHR)–based disease registries have aided health care professionals and researchers in increasing their understanding of chronic illnesses, including identifying patients with (or at risk of developing) conditions and tracking treatment progress and recovery. Despite excessive alcohol use being a major contributor to the global burden of disease and disability, no registries of alcohol problems exist. EHR-based data in Kaiser Permanente Northern California (KPNC), an integrated health system that conducts systematic alcohol screening, which provides specialty addiction medicine treatment internally and has a membership of over 4 million members that are highly representative of the US population with access to care, provide a unique opportunity to develop such a registry. Objective Our objectives were to describe the development and implementation of a protocol for assembling the KPNC Adult Alcohol Registry, which may be useful to other researchers and health systems, and to characterize the registry cohort descriptively, including underlying health conditions. Methods Inclusion criteria were adult members with unhealthy alcohol use (using National Institute on Alcohol Abuse and Alcoholism guidelines), an alcohol use disorder (AUD) diagnosis, or an alcohol-related health problem between June 1, 2013, and May 31, 2019. We extracted patients’ longitudinal, multidimensional EHR data from 1 year before their date of eligibility through May 31, 2019, and conducted descriptive analyses. Results We identified 723,604 adult patients who met the registry inclusion criteria at any time during the study period: 631,780 with unhealthy alcohol use, 143,690 with an AUD diagnosis, and 18,985 with an alcohol-related health problem. We identified 65,064 patients who met two or more criteria. Of the 4,973,195 adult patients with at least one encounter with the health system during the study period, the prevalence of unhealthy alcohol use was 13% (631,780/4,973,195), the prevalence of AUD diagnoses was 3% (143,690/4,973,195), and the prevalence of alcohol-related health problems was 0.4% (18,985/4,973,195). The registry cohort was 60% male (n=432,847) and 41% non-White (n=295,998) and had a median age of 41 years (IQR=27). About 48% (n=346,408) had a chronic medical condition, 18% (n=130,031) had a mental health condition, and 4% (n=30,429) had a drug use disorder diagnosis. Conclusions We demonstrated that EHR-based data collected during clinical care within an integrated health system could be leveraged to develop a registry of patients with alcohol problems that is flexible and can be easily updated. The registry’s comprehensive patient-level data over multiyear periods provides a strong foundation for robust research addressing critical public health questions related to the full course and spectrum of alcohol problems, including recovery, which would complement other methods used in alcohol research (eg, population-based surveys, clinical trials).

scholarly journals The Kaiser Permanente Northern California Adult Alcohol Registry, an Electronic Health Records-Based Registry of Patients With Alcohol Problems: Development and Implementation (Preprint)

2020 ◽  
Author(s):  
Vanessa A Palzes ◽  
Constance Weisner ◽  
Felicia W Chi ◽  
Andrea H Kline-Simon ◽  
Derek D Satre ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Health System ◽  
Health Problem ◽  
Alcohol Problems ◽  
Adult Patients ◽  
Northern California ◽  
Inclusion Criteria ◽  
Kaiser Permanente ◽  
Unhealthy Alcohol Use ◽  
Unhealthy Alcohol

BACKGROUND Electronic health record (EHR)–based disease registries have aided health care professionals and researchers in increasing their understanding of chronic illnesses, including identifying patients with (or at risk of developing) conditions and tracking treatment progress and recovery. Despite excessive alcohol use being a major contributor to the global burden of disease and disability, no registries of alcohol problems exist. EHR-based data in Kaiser Permanente Northern California (KPNC), an integrated health system that conducts systematic alcohol screening, which provides specialty addiction medicine treatment internally and has a membership of over 4 million members that are highly representative of the US population with access to care, provide a unique opportunity to develop such a registry. OBJECTIVE Our objectives were to describe the development and implementation of a protocol for assembling the KPNC Adult Alcohol Registry, which may be useful to other researchers and health systems, and to characterize the registry cohort descriptively, including underlying health conditions. METHODS Inclusion criteria were adult members with unhealthy alcohol use (using National Institute on Alcohol Abuse and Alcoholism guidelines), an alcohol use disorder (AUD) diagnosis, or an alcohol-related health problem between June 1, 2013, and May 31, 2019. We extracted patients’ longitudinal, multidimensional EHR data from 1 year before their date of eligibility through May 31, 2019, and conducted descriptive analyses. RESULTS We identified 723,604 adult patients who met the registry inclusion criteria at any time during the study period: 631,780 with unhealthy alcohol use, 143,690 with an AUD diagnosis, and 18,985 with an alcohol-related health problem. We identified 65,064 patients who met two or more criteria. Of the 4,973,195 adult patients with at least one encounter with the health system during the study period, the prevalence of unhealthy alcohol use was 13% (631,780/4,973,195), the prevalence of AUD diagnoses was 3% (143,690/4,973,195), and the prevalence of alcohol-related health problems was 0.4% (18,985/4,973,195). The registry cohort was 60% male (n=432,847) and 41% non-White (n=295,998) and had a median age of 41 years (IQR=27). About 48% (n=346,408) had a chronic medical condition, 18% (n=130,031) had a mental health condition, and 4% (n=30,429) had a drug use disorder diagnosis. CONCLUSIONS We demonstrated that EHR-based data collected during clinical care within an integrated health system could be leveraged to develop a registry of patients with alcohol problems that is flexible and can be easily updated. The registry’s comprehensive patient-level data over multiyear periods provides a strong foundation for robust research addressing critical public health questions related to the full course and spectrum of alcohol problems, including recovery, which would complement other methods used in alcohol research (eg, population-based surveys, clinical trials).

scholarly journals Health System‐Based Unhealthy Alcohol Use Screening and Treatment Comparing Demographically Matched Participants With and Without HIV

2020 ◽  
Vol 44 (12) ◽  
pp. 2545-2554
Author(s):  
Michael J. Silverberg ◽  
Tory Levine‐Hall ◽  
Nicole Hood ◽  
Alexandra N. Anderson ◽  
Stacey E. Alexeeff ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Health System ◽  
Unhealthy Alcohol Use ◽  
Unhealthy Alcohol

Unhealthy alcohol use independently associated with unfavorable TB treatment outcomes among Indian men

2021 ◽  
Vol 25 (3) ◽  
pp. 182-190
Author(s):  
S. R. Cox ◽  
A. N. Gupte ◽  
B. Thomas ◽  
S. Gaikwad ◽  
V. Mave ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Treatment Outcomes ◽  
Unfavorable Outcome ◽  
Unhealthy Alcohol Use ◽  
Unhealthy Alcohol ◽  
Tb Treatment ◽  
Alcohol Interventions ◽  
Increased Risk ◽  
Adjusted Incidence Rate ◽  
Indian Men

BACKGROUND: Approximately 10% of incident TB cases worldwide are attributable to alcohol. However, evidence associating alcohol with unfavorable TB treatment outcomes is weak.METHODS: We prospectively evaluated men (≥18 years) with pulmonary TB in India for up to 24 months to investigate the association between alcohol use and treatment outcomes. Unhealthy alcohol use was defined as a score of ≥4 on the Alcohol Use Disorders Identification Test-Concise (AUDIT-C) scale at entry. Unfavorable TB treatment outcomes included failure, recurrence, and all-cause mortality, analyzed as composite and independent endpoints.RESULTS: Among 751 men, we identified unhealthy alcohol use in 302 (40%). Median age was 39 years (IQR 28–50); 415 (55%) were underweight (defined as a body mass index [BMI] <18.5 kg/m2); and 198 (26%) experienced an unfavorable outcome. Unhealthy alcohol use was an independent risk factor for the composite unfavorable outcome (adjusted incidence rate ratio [aIRR] 1.47, 95% CI 1.05–2.06; P = 0.03) and death (aIRR 1.90, 95% CI 1.08–3.34; P = 0.03), specifically. We found significant interaction between AUDIT-C and BMI; underweight men with unhealthy alcohol use had increased risk of unfavorable outcomes (aIRR 2.22, 95% CI 1.44–3.44; P < 0.001) compared to men with BMI ≥18.5 kg/m2 and AUDIT-C <4.CONCLUSION: Unhealthy alcohol use was independently associated with unfavorable TB treatment outcomes, highlighting the need for integrating effective alcohol interventions into TB care.

scholarly journals Does readiness to change predict subsequent alcohol consumption in medical inpatients with unhealthy alcohol use?

2009 ◽  
Vol 34 (8) ◽  
pp. 636-640 ◽  
Author(s):  
Nicolas Bertholet ◽  
Debbie M. Cheng ◽  
Tibor P. Palfai ◽  
Jeffrey H. Samet ◽  
Richard Saitz
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
Readiness To Change ◽  
Unhealthy Alcohol Use ◽  
Unhealthy Alcohol ◽  
Medical Inpatients

scholarly journals Mobile Health Interventions for Self-Control of Unhealthy Alcohol Use: Systematic Review (Preprint)

2018 ◽  
Author(s):  
Ting Song ◽  
Siyu Qian ◽  
Ping Yu
Keyword(s):  
Alcohol Use ◽  
Health Outcomes ◽  
Mobile Health ◽  
Full Text ◽  
Self Control ◽  
Statistical Testing ◽  
Unhealthy Alcohol Use ◽  
Unhealthy Alcohol ◽  
The Core ◽  
Core Components

BACKGROUND Unhealthy alcohol use (UAU) is one of the major causes of preventable morbidity, mortality, and associated behavioral risks worldwide. Although mobile health (mHealth) interventions can provide consumers with an effective means for self-control of UAU in a timely, ubiquitous, and cost-effective manner, to date, there is a lack of understanding about different health outcomes brought by such interventions. The core components of these interventions are also unclear. OBJECTIVE This study aimed to systematically review and synthesize the research evidence about the efficacy of mHealth interventions on various health outcomes for consumer self-control of UAU and to identify the core components to achieve these outcomes. METHODS We systematically searched 7 electronic interdisciplinary databases: Scopus, PubMed, PubMed Central, CINAHL Plus with full text, MEDLINE with full text, PsycINFO, and PsycARTICLES. Search terms and Medical Subject Headings “mHealth,” “text message,” “SMS,” “App,” “IVR,” “self-control,” “self-regulation,” “alcohol*,” and “intervention” were used individually or in combination to identify peer-reviewed publications in English from 2008 to 2017. We screened titles and abstracts and assessed full-text papers as per inclusion and exclusion criteria. Data were extracted from the included papers according to the Consolidated Standards of Reporting Trials-EHEALTH checklist (V 1.6.1) by 2 authors independently. Data quality was assessed by the Mixed Methods Appraisal Tool. Data synthesis and analyses were conducted following the procedures for qualitative content analysis. Statistical testing was also conducted to test differences among groups of studies. RESULTS In total, 19 studies were included in the review. Of these 19 studies, 12 (63%) mHealth interventions brought significant positive outcomes in improving participants’ health as measured by behavioral (n=11), physiological (n=1), and cognitive indicators (n=1). No significant health outcome was reported in 6 studies (6/19, 32%). Surprisingly, a significant negative outcome was reported for the male participants in the intervention arm in 1 study (1/19, 5%), but no change was found for the female participants. In total, 5 core components reported in the mHealth interventions for consumer self-control of UAU were context, theoretical base, delivery mode, content, and implementation procedure. However, sound evidence is yet to be generated about the role of each component for mHealth success. The health outcomes were similar regardless of types of UAU, deployment setting, with or without nonmobile cointervention, and with or without theory. CONCLUSIONS Most studies reported mHealth interventions for self-control of UAU appeared to be improving behavior, especially the ones delivered by short message service and interactive voice response systems. Further studies are needed to gather sound evidence about the effects of mHealth interventions on improving physiological and cognitive outcomes as well as the optimal design of these interventions, their implementation, and effects in supporting self-control of UAU.

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