[
  {
    "phenotype_id": "PH692",
    "phenotype_version_id": 1384,
    "name": "Case Definition for Alcohol Dependence",
    "definition": "Aim:\n\nTo evaluate drug therapy for alcohol dependence in the 12 months after first diagnosis in UK primary care.\n\n\nDesign:\n\nOpen cohort study.\n\n\nSetting:\n\nGeneral practices contributing data to the UK Clinical Practice Research Database.\n\n\nParticipants:\n\n39,980 people with an incident diagnosis of alcohol dependence aged 16 years or older between 1 January 1990 and 31 December 2013.\n\n\nMain outcome measure:\n\nUse of pharmacotherapy (acamprosate, disulfiram, naltrexone, baclofen and topiramate) to promote abstinence from alcohol or reduce drinking to safe levels in the first 12 months after a recorded diagnosis of alcohol dependence.\n\n\nFindings:\n\nOnly 4,677 (11.7%) of the cohort received relevant pharmacotherapy in the 12 months following diagnosis. Of the 35,303 that did not receive pharmacotherapy, 3,255 (9.2%) received psychosocial support. The remaining 32,048 (80.2%) did not receive either mode of treatment in the first 12 months. Factors that independently reduced the likelihood of receiving pharmacotherapy included: being male (Odds Ratio [OR] 0.74; 95% CI 0.69 to 0.78); older (65-74 years: OR 0.61; 95% CI 0.49 to 0.77); being from a practice based in the most deprived quintile (OR 0.58; 95% CI 0.53 to 0.64); and being located in Northern Ireland (OR 0.78; 95% CI 0.67 to 0.91). The median duration to initiation of pharmacotherapy was 0.80 months (95% CI 0.70 to 1.00) for acamprosate and 0.60 months (95% CI 0.43 to 0.73) for disulfiram. Persistence analysis for those receiving acamprosate and disulfiram revealed that many patients never received a repeat prescription; persistence at 6 months was 27.7% for acomprosate and 33.2% for disulfiram. The median duration of therapy was 2.10 months (95% CI 1.87 to 2.53) for acamprosate and 3.13 months (95% CI 2.77 to 3.36) for disulfiram.\n\n\nConclusion: \n\nDrug therapy to promote abstinence in alcohol dependent patients was low, with the majority of patients receiving no therapy, either psychological or pharmacological. When drug therapy was prescribed, persistence was low with most patients receiving only one prescription. Our data show that treatment for alcohol dependence is haphazard, and there is an urgent need to explore strategies for improving clinical management of this patient group.\n\n\n\n\n\n\n\n\n",
    "implementation": "",
    "publications": [
      {
        "doi": null,
        "details": "Andrew Thompson, Darren M Ashcroft, Lynn Owens, Tjeerd P Van Staa, Munir Pirmohamed, Drug therapy for alcohol dependence in primary care in the UK A Clinical Practice Research Datalink study. POLS ONE, 12(3), e0173272, 2017."
      }
    ],
    "validation": "",
    "citation_requirements": "",
    "created": "2021-10-06T16:30:23.610753Z",
    "author": "Andrew Thompson, Darren M Ashcroft, Lynn Owens, Tjeerd P Van Staa, Munir Pirmohamed",
    "collections": [
      {
        "name": "ClinicalCodes Repository",
        "value": 25
      },
      {
        "name": "Phenotype Library",
        "value": 18
      }
    ],
    "tags": null,
    "organisation": null,
    "world_access": 1,
    "updated": "2021-10-06T16:30:23.610781Z",
    "sex": [
      {
        "name": "Both",
        "value": "3"
      }
    ],
    "type": [
      {
        "name": "Lifestyle risk factor",
        "value": "4"
      }
    ],
    "ontology": null,
    "phenoflowid": "",
    "data_sources": [
      {
        "name": "CPRD GOLD",
        "value": 5,
        "uid": "a29feafa-7bdd-44e9-b977-c9d26425e67f",
        "url": "https://healthdatagateway.org/en/dataset/694",
        "datasource_id": 694
      }
    ],
    "coding_system": [
      {
        "name": "Read codes v2",
        "value": 5
      }
    ],
    "event_date_range": "01/01/1990 - 31/12/2013",
    "concept_information": [
      {
        "concept_id": 2112,
        "concept_version_id": 5362,
        "concept_name": "Case Definition for Alcohol Dependence - Primary Care",
        "coding_system": {
          "id": 5,
          "name": "Read codes v2",
          "description": "Read codes v2"
        },
        "phenotype_id": "PH692",
        "phenotype_version_id": 1384,
        "phenotype_name": "Case Definition for Alcohol Dependence",
        "code_attribute_header": [
          "Entity type",
          "Category",
          "Coding System (Read)"
        ],
        "codes": [
          {
            "code": "8BA8.00",
            "description": "alcohol detoxification",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "8H35.00",
            "description": "admitted to alcohol detoxification centre",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E010.00",
            "description": "Alcohol withdrawal delirium",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E010.12",
            "description": "Delirium tremens",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E012000",
            "description": "Chronic alcoholic brain syndrome",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E013.00",
            "description": "Alcohol withdrawal hallucinosis",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E01y000",
            "description": "Alcohol withdrawal syndrome",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E23..00",
            "description": "Alcohol dependence syndrome",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E230.00",
            "description": "Acute alcoholic intoxication in alcoholism",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E230000",
            "description": "Acute alcoholic intoxication, unspecified, in alcoholism",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E230100",
            "description": "Continuous acute alcoholic intoxication in alcoholism",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E230.11",
            "description": "Alcohol dependence with acute alcoholic intoxication",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E230300",
            "description": "Acute alcoholic intoxication in remission, in alcoholism",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E230z00",
            "description": "Acute alcoholic intoxication in alcoholism NOS",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E231.00",
            "description": "Chronic alcoholism",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E23..11",
            "description": "Alcoholism",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E231100",
            "description": "Continuous chronic alcoholism",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E231.11",
            "description": "Dipsomania",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E231300",
            "description": "Chronic alcoholism in remission",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E231z00",
            "description": "Chronic alcoholism NOS",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "E23z.00",
            "description": "Alcohol dependence syndrome NOS",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu10200",
            "description": "[X]Mental and behavioural disorders due to use of alcohol: dependence syndrome",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu10211",
            "description": "[X]Alcohol addiction",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu10212",
            "description": "[X]Chronic alcoholism",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu10213",
            "description": "[X]Dipsomania",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu10300",
            "description": "[X]Mental and behavioural disorders due to use of alcohol: withdrawal state",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu10400",
            "description": "[X]Mental and behavioural disorders due to use of alcohol: withdrawal state with delirium",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu10411",
            "description": "[X]Delirium tremens, alcohol induced",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu10712",
            "description": "[X]Chronic alcoholic brain syndrome",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Eu10800",
            "description": "[X]Alcohol withdrawal-induced seizure",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "F11x000",
            "description": "Cerebral degeneration due to alcoholism",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "F11x011",
            "description": "Alcoholic encephalopathy",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "F375.00",
            "description": "Alcoholic polyneuropathy",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "F394100",
            "description": "Alcoholic myopathy",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "G555.00",
            "description": "Alcoholic cardiomyopathy",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "J612.00",
            "description": "Alcoholic cirrhosis of liver",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "J617000",
            "description": "Chronic alcoholic hepatitis",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "J671000",
            "description": "Alcohol-induced chronic pancreatitis",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          },
          {
            "code": "Z191.00",
            "description": "alcohol detoxification",
            "attributes": {
              "Entity type": "res58: case definition for alcohol dependence",
              "Category": "diagnostic",
              "Coding System (Read)": "Read"
            }
          }
        ]
      }
    ],
    "status": 2,
    "doi": "https://doi.org/10.48533/0900-2e90",
    "is_deleted": null,
    "publish_status": 2,
    "owner": "ieuan.scanlon",
    "template": {
      "id": 1,
      "name": "Clinical-Coded Phenotype",
      "description": "Phenotype definitions that are based on lists of clinical codes, or algorithms using clinical codes.",
      "version_id": 1
    },
    "versions": [
      {
        "version_id": 1384,
        "version_name": "Case Definition for Alcohol Dependence",
        "version_date": "2021-10-06T16:30:23.638173Z",
        "is_published": true,
        "is_latest": true
      }
    ]
  }
]