Healthcare utilisation, morbidities and alcohol use monitoring prior to alcoholic psychosis diagnosis

Otete, Harmony; Fleming, Kate M.; West, Joe; Orton, Elizabeth

Abstract

Aims: This study aimed to describe healthcare utilisation, morbidities and monitoring of alcohol use in patients prior to a diagnosis of alcoholic psychosis in order to inform the early identification of patients at risk.

Method: Using linked general practice and hospitalisation data in England (April 1997 to June 2014) we identified 1,731 individuals (≥ 18 years) with a clinical recorded diagnosis of alcoholic psychosis and 17,310 matched controls without the disorder. We examined all prior general practitioner (family doctor) visits, hospitalisations, medically-recorded morbidities, alcohol assessment/interventions records. Poisson regression models were used to compare rates of healthcare utilisation in people with alcoholic psychosis to those without. Logistic regression models were used to evaluate the association between alcoholic psychosis and prior morbidities.

Results: Patients with alcoholic psychosis showed increased levels of healthcare utilisation at least 5 years prior to their diagnosis. The most common reasons for prior healthcare visits were seizures and injuries and there was more than 4-fold higher rate of seizures, unintentional injuries and self-harm incidents among these patients up to 10 years prior to diagnosis, compared to the control population. A high proportion (78%) of patients had their alcohol consumption recorded, 50% had a record of heavy drinking but only 1 in 5 had any evidence of receiving an alcohol-related intervention.

Conclusion: Patients present more often with seizures and injuries than the general population several years prior to a diagnosis of alcoholic psychosis. These visits represent opportunities for preventive action and imply that we may be missing opportunities to intervene.

Citation

Otete, H., Fleming, K. M., West, J., & Orton, E. (2019). Healthcare utilisation, morbidities and alcohol use monitoring prior to alcoholic psychosis diagnosis. Alcohol and Alcoholism, 54(2), 131–138. https://doi.org/10.1093/alcalc/agy085

• Journal Article Type: Article
• Acceptance Date: Nov 13, 2018
• Online Publication Date: Dec 20, 2018
• Publication Date: 2019-03
• Deposit Date: Nov 13, 2018
• Publicly Available Date: Dec 21, 2019
• Journal: Alcohol and Alcoholism
• Print ISSN: 0735-0414
• Electronic ISSN: 1464-3502
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 54
• Issue: 2
• Pages: 131–138
• DOI: https://doi.org/10.1093/alcalc/agy085
• Public URL: https://nottingham-repository.worktribe.com/output/1246267
• Publisher URL: https://academic.oup.com/alcalc/advance-article/doi/10.1093/alcalc/agy085/5253749
• Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in Alcohol and Alcoholism following peer review. The version of record is available online at: https://academic.oup.com/alcalc/advance-article/doi/10.1093/alcalc/agy085/5253749