Modelling the consequences of a reduction in alcohol consumption among patients with alcohol dependence based on real-life observational data.

Details

Ressource 1Download: BIB_2100B17F1138.P001.pdf (477.12 [Ko])
State: Public
Version: Final published version
Serval ID
serval:BIB_2100B17F1138
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Modelling the consequences of a reduction in alcohol consumption among patients with alcohol dependence based on real-life observational data.
Journal
Bmc Public Health
Author(s)
Rahhali N., Millier A., Briquet B., Laramée P., Aballéa S., Toumi M., François C., Rehm J., Daeppen J.B.
ISSN
1471-2458 (Electronic)
ISSN-L
1471-2458
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
15
Number
1
Pages
1271
Language
english
Notes
Publication types: Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Abstract
BACKGROUND: Most available pharmacotherapies for alcohol-dependent patients target abstinence; however, reduced alcohol consumption may be a more realistic goal. Using randomized clinical trial (RCT) data, a previous microsimulation model evaluated the clinical relevance of reduced consumption in terms of avoided alcohol-attributable events. Using real-life observational data, the current analysis aimed to adapt the model and confirm previous findings about the clinical relevance of reduced alcohol consumption.
METHODS: Based on the prospective observational CONTROL study, evaluating daily alcohol consumption among alcohol-dependent patients, the model predicted the probability of drinking any alcohol during a given day. Predicted daily alcohol consumption was simulated in a hypothetical sample of 200,000 patients observed over a year. Individual total alcohol consumption (TAC) and number of heavy drinking days (HDD) were derived. Using published risk equations, probabilities of alcohol-attributable adverse health events (e.g., hospitalizations or death) corresponding to simulated consumptions were computed, and aggregated for categories of patients defined by HDDs and TAC (expressed per 100,000 patient-years). Sensitivity analyses tested model robustness.
RESULTS: Shifting from >220 HDDs per year to 120-140 HDDs and shifting from 36,000-39,000 g TAC per year (120-130 g/day) to 15,000-18,000 g TAC per year (50-60 g/day) impacted substantially on the incidence of events (14,588 and 6148 events avoided per 100,000 patient-years, respectively). Results were robust to sensitivity analyses.
CONCLUSIONS: This study corroborates the previous microsimulation modeling approach and, using real-life data, confirms RCT-based findings that reduced alcohol consumption is a relevant objective for consideration in alcohol dependence management to improve public health.
Keywords
Adult, Alcohol Abstinence/statistics & numerical data, Alcohol Drinking/epidemiology, Alcoholism/epidemiology, Computer Simulation, Female, Hospitalization/statistics & numerical data, Humans, Male, Middle Aged, Models, Theoretical, Prospective Studies, Public Health
Pubmed
Web of science
Open Access
Yes
Create date
10/02/2016 16:06
Last modification date
20/08/2019 12:57
Usage data