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

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

Authors

Harmony Otete

Kate M. Fleming

JOE WEST JOE.WEST@NOTTINGHAM.AC.UK
Professor of Epidemiology



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 (OUP)
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.co...3/alcalc/agy085/5253749

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