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Psychosocial Support

Andrew Thompson, Darren M Ashcroft, Lynn Owens, Tjeerd P Van Staa, Munir Pirmohamed

Type
Lifestyle Risk Factor
ID
PH693
Version ID
1386
Data Sources
Valid event data range
01/01/1990 - 31/12/2013
Sex
Female, Male
Agreement Date
2017-03-20
Coding system
Read codes v2
Tags /Collections
ClinicalCodes Repository Phenotype Library

Definition

Aim:

To evaluate drug therapy for alcohol dependence in the 12 months after first diagnosis in UK primary care.

Design:

Open cohort study.

Setting:

General practices contributing data to the UK Clinical Practice Research Database.

Participants:

39,980 people with an incident diagnosis of alcohol dependence aged 16 years or older between 1 January 1990 and 31 December 2013.

Main outcome measure:

Use 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.

Findings:

Only 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.

Conclusion:

Drug 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.

Publications

  • 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.

Clinical Code List

Rows: 24
Code Description Entity type Category Coding System (Read)
13Y8.00 Alcoholics anonymous res58: psychosocial support diagnostic Read
66e0.00 Alcohol abuse monitoring res58: psychosocial support diagnostic Read
7P22100 Delivery of rehabilitation for alcohol addiction res58: psychosocial support diagnostic Read
8CAv.00 Advised to contact primary care alcohol worker res58: psychosocial support diagnostic Read
8H7p.00 Referral to community alcohol team res58: psychosocial support diagnostic Read
8HHe.00 Referral to community drug and alcohol team res58: psychosocial support diagnostic Read
8HkG.00 Referral to specialist alcohol treatment service res58: psychosocial support diagnostic Read
8HkJ.00 Referral to alcohol brief intervention service res58: psychosocial support diagnostic Read
8IAF.00 brief intervention for excessive alcohol consumptn declined res58: psychosocial support diagnostic Read
8IAJ.00 Declined referral to specialist alcohol treatment service res58: psychosocial support diagnostic Read
8IAt.00 Extended intervention for excessive alcohol consumption declined res58: psychosocial support diagnostic Read
8IEA.00 Referral to community alcohol team declined res58: psychosocial support diagnostic Read
9NN2.00 Under care of community alcohol team res58: psychosocial support diagnostic Read
9k1..00 Alcohol misuse - enhanced services administration res58: psychosocial support diagnostic Read
9k11.00 Alcohol consumption counselling res58: psychosocial support diagnostic Read
9k12.00 Alcohol misuse - enhanced service completed res58: psychosocial support diagnostic Read
9k14.00 Alcohol counselling by other agencies res58: psychosocial support diagnostic Read
9k1A.00 Brief intervention for excessive alcohol consumption completed res58: psychosocial support diagnostic Read
9k1B.00 Extended intervention for excessive alcohol consumption completed res58: psychosocial support diagnostic Read
Z191100 alcohol withdrawal regime res58: psychosocial support diagnostic Read
Z191211 alcohol reduction programme res58: psychosocial support diagnostic Read
Z4B1.00 Alcoholism counselling res58: psychosocial support diagnostic Read
ZV57A00 [V]Alcohol rehabilitation res58: psychosocial support diagnostic Read
ZV6D600 [V]Alcohol abuse counselling and surveillance res58: psychosocial support diagnostic Read

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH693/version/1386/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH693/version/1386/detail/?format=json
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get details of phenotype

details = get_phenotype_detail_by_version('PH693', '1386', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH693/version/1386/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH693/version/1386/export/codes/?format=json
CSV site_root/phenotypes/PH693/version/1386/export/codes/
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get codelists of phenotype

codelists = get_phenotype_code_list('PH693', '1386', api_client=client)

Version History

Version
ID
Name Owner Publish date
1386 Psychosocial Support ieuan.scanlon 2021-10-06 currently shown

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