Abstract
This study aims to investigate the incidence and annual presentation rates of alcohol dependence in general practice in the UK, and examine age-, gender-, socioeconomic-, and region-specific variation. We conducted a retrospective 'open' cohort study using the Clinical Practice Research Datalink (CPRD), an anonymised primary care database. Prior to data extraction, a case definition for alcohol dependence in CPRD was established using 47 Read codes, which included primary alcohol dependence and consequences of alcohol dependence. Directly standardised rates for incidence and annual presentation were calculated for each year between 1990 and 2013. Rates were compared by gender, age, UK home nation, and practice-level Index of Multiple Deprivation. The directly standardised annual incidence rates were 8.3 and 3.7 per 10,000 male and female patients, respectively. The estimated annual rates of presentation per 10,000 were 17.1 for males and 7.6 for females. Female to male rate ratios were: 0.40 (95% CI: 0.39–0.41) for incident cases; and 0.37 (95% CI: 0.36–0.39) for annual presentation. Rates were highest in those aged 35–54 for both measures and across genders, and lowest in those aged over 75 years. With England as the reference nation, Northern Ireland and Scotland had significantly higher rates for both measures. Patients from the most deprived areas had the highest incidence and annual presentation rates. There is unequal distribution of patients with severe alcohol dependence across population subgroups in general practice. Given the health and economic burden associated with dependent drinking, these data will be useful in informing future public health initiatives.
Highlights
Alcohol dependence manifests from chronic, repeated exposure to ethanol which results in a cluster of behavioural, neurological, and physiological adaptations [1]
For history of alcohol dependence, we explored previous Read codes, and the duration of previous time at risk for each patient was dependent on their time registered at a General Practitioners (GPs) practice that is included in Clinical Practice Research Datalink (CPRD)
When our case definition was applied to the complete CPRD database, we identified 128,174 cases of alcohol dependence
Summary
Alcohol dependence manifests from chronic, repeated exposure to ethanol which results in a cluster of behavioural, neurological, and physiological adaptations [1]. In the United Kingdom (UK), most of the evidence on alcohol dependence has arisen from large-scale population surveys that utilise screening tools, such as the alcohol use disorders identification test (AUDIT) or severity of alcohol dependence questionnaire (SADQ), and/or quantity frequency methods rather than clinical diagnoses Such an approach can be time efficient and enable substantial coverage, but can lead to biases: Selection bias can arise as patients from certain populations are not included (e.g. homeless, university students occupying halls of residents, and military personnel); responder bias from participants knowingly or unknowingly misreporting—for example, it is estimated that self-reported alcohol consumption underrepresents alcohol sales by 40–60% [5, 6]; and, non-response bias [7]. The most recent national survey, which was undertaken in England, estimates prevalence of alcohol dependence to be 5.9% [8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
