The Relationship Between Reductions in WHO Risk Drinking Levels During Treatment and Subsequent Healthcare Costs for the ACTIVE Workgroup.
The Relationship Between Reductions in WHO Risk Drinking Levels During Treatment and Subsequent Healthcare Costs for the ACTIVE Workgroup.
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ACTIVE工作组在治疗期间降低WHO风险饮酒水平与随后的医疗保健费用之间的关系。
DOI：
10.1097/adm.0000000000000925
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发表时间：
2022-07-01
影响因子：
5.5
通讯作者：
中科院分区：
文献类型：
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作者：
戒酒历来被认为是酒精使用障碍（AUD）治疗的目标结果，但最近的研究发现，根据世界卫生组织（WHO）的风险饮酒水平，AUD治疗后饮酒减少与功能，身体健康和生活质量的有意义的改善有关。这项研究通过估计WHO风险饮酒水平（非常高、高、中和低，基于平均每日饮酒量）变化与医疗保健费用之间的相关性，扩展了之前对AUD治疗结局的分析。联合收割机研究的次要数据分析，这是一项关于阿坎酸、纳洛酮和行为干预治疗AUD的多中心随机临床试验。广义伽马回归模型用于估计治疗过程中WHO风险饮酒水平降低与治疗后一年（N=964）和治疗后3年（N=651）医疗保健费用之间的关系。在整个治疗过程中，WHO风险饮酒持续降低2个或更多水平与治疗后一年的医疗费用降低52.0%（p < 0.001）和3年内的医疗费用降低44.0%（p = 0.0025）相关。降低1个水平与3年内成本降低34.8%相关，但不显著（p=0.05）。住院患者行为健康和急诊科利用率降低推动了成本降低。世卫组织风险饮酒水平降低至少2个水平与1年和3年的医疗费用降低相关。我们的研究结果补充了文献，表明饮酒减少与健康改善有关。
Abstinence has historically been considered the target outcome for alcohol use disorder (AUD) treatment, yet recent work has found drinking reductions following AUD treatment, as measured by World Health Organization (WHO) risk drinking levels, are associated with meaningful improvements in functioning, physical health, and quality of life. This study extends previous analyses of AUD treatment outcomes by estimating the association between changes in WHO risk drinking levels (very high, high, medium, and low, based on average daily alcohol consumption) and healthcare costs. Secondary data analysis of the COMBINE study, a multi-site randomized clinical trial of acamprosate, naltrexone and behavioral interventions for AUD. Generalized gamma regression models were used to estimate relationships between WHO risk drinking level reductions over the course of treatment and healthcare costs in the year after treatment (N=964) and up to 3 years following treatment (N=651). Sustained WHO risk drinking reductions of 2 or more levels throughout treatment were associated with 52.0% lower healthcare costs (p < 0.001) in the year following treatment, and 44.0% lower costs (p = 0.0025) over 3 years. A reduction of exactly 1 level was associated with 34.8% lower costs over 3 years, which was not significant (p=0.05). Cost reductions were driven by lower inpatient behavioral health and emergency department utilization. Reduction in WHO risk drinking levels of at least 2 levels was associated with lower healthcare costs over 1 and 3 years. Our results add to literature showing drinking reductions are associated with improvement in health.