Adherence to Prescribed Acamprosate in Alcohol Dependence and 1-Year Morbidities and Mortality: Utilizing a Data Linkage Methodology
1. Background and Significance
3. Materials and Methods
3.2. Individuals on Acamprosate
3.3. Ethical, Information, and Research Governance
3.4. Calculation of Adherence
- We categorized individuals as having good adherence to acamprosate if the adherence index was ≥80%;
- We categorized individuals as having low adherence to acamprosate if the adherence index was <80%.
3.5. Datasets and Data Linkage
- Cardiovascular: e.g., chronic ischemic heart disease, cardiomyopathy, heart failure;
- Cerebrovascular: e.g., intracerebral hemorrhage, cerebral infarction, cerebral aneurysm;
- Neoplasm: e.g., neoplasm of the pancreas, neoplasm of the liver;
- Poisoning: e.g., poisoning by narcotics, poisoning by topical agents, poisoning by nonopioid analgesics;
- Respiratory: e.g., pulmonary disease, pneumonia, bronchitis, respiratory failure;
- Mental and behavioral disorder: e.g., anxiety, obsessive compulsive disorder, stress, mood disorder, schizophrenia, withdrawal state with delirium;
- Hepatic: e.g., cirrhosis, liver disease, chronic hepatitis;
- Gastrointestinal: e.g., gastro-esophageal reflux disease, gastrointestinal hemorrhage, gastroenteritis, and colitis.
- Not direct: cardiovascular, cerebrovascular, neoplasm, poisoning and respiratory;
- Direct: alcohol-related and unspecified alcohol issues, hepatic, gastrointestinal and alcohol-related causes on the certificate of death.
- Not direct: acute stress, mood disorder, anxiety and panic attack;
- Direct: mental and behavioral disorders due to use of alcohol and alcohol induced conditions (e.g., withdrawal, harmful use, dependence and hallucinations).
3.6. Statistical Methods
4.1. Descriptive Statistics
4.2.1. Medical Admissions (SMR01)
4.2.2. Psychiatric Admissions (SMR04)
4.2.3. Accident and Emergency (A&E) Admissions
4.2.4. Other Medication as Proxy Measure of Morbidities
4.3. Cause of Death
4.4. Multivariable Associations between Covariates and Causes of Mortality
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
- World Health Organization. Global Status Report on Alcohol and Health 2018: Executive Summary; World Health Organization: Geneva, Switzerland, 2018. [Google Scholar]
- World Health Organization, Division of Mental Health and Prevention of Substance Abuse. WHOQOL: Measuring Quality of Life; World Health Organization: Geneva, Switzerland, 1997; Available online: https://apps.who.int/iris/handle/10665/63482 (accessed on 28 December 2020).
- Cohen, E.; Feinn, R.; Arias, A.; Kranzler, H.R. Alcohol treatment utilization: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions. Drug Alcohol Depend. 2007, 86, 214–221. [Google Scholar] [CrossRef] [PubMed]
- National Institute on Alcohol Abuse and Alcoholism (NIAAA). Alcohol Use Disorder. Available online: https://www.niaaa.nih.gov/alcohols-effects-health/alcohol-use-disorder (accessed on 29 December 2020).
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5; American Psychiatric Publishing: Arlinghton, VA, USA; Washington, DC, USA, 2013. [Google Scholar]
- May, C.; Nielsen, A.S.; Bilberg, R. Barriers to treatment for alcohol dependence. J. Drug Alcohol Res. 2019, 8, 236083. [Google Scholar]
- Tuithof, M.; Have, M.T.; Brink, W.V.D.; Vollebergh, W.; De Graaf, R. Treatment Seeking for Alcohol Use Disorders: Treatment Gap or Adequate Self-Selection? Eur. Addict. Res. 2016, 22, 277–285. [Google Scholar] [CrossRef] [PubMed]
- Witkiewitz, K.; Litten, R.Z.; Leggio, L. Advances in the science and treatment of alcohol use disorder. Sci. Adv. 2019, 5, eaax4043. [Google Scholar] [CrossRef] [PubMed][Green Version]
- The Long-Term Cost-Effectiveness of Improving Alcohol Abstinence with Adjuvant Acamprosate. Available online: https://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=22000001847&ID=22000001847 (accessed on 24 December 2020).
- Thompson, A.; Ashcroft, D.M.; Owens, L.; van Staa, T.P.; Pirmohamed, M. Drug therapy for alcohol dependence in primary care in the UK: A Clinical Practice Research Datalink study. PLoS ONE 2017, 12, e0173272. [Google Scholar] [CrossRef]
- National Health Service (NHS). Community Health Index (CHI). Available online: https://datadictionary.nhs.uk/attributes/community_health_index_number.html (accessed on 28 December 2020).
- NHS Scotland. Available online: https://www.scot.nhs.uk/about-nhs-scotland/ (accessed on 28 December 2020).
- SMR Datasets. Available online: https://www.ndc.scot.nhs.uk/Data-Dictionary/SMR-Datasets/index.asp?Co=Y (accessed on 28 December 2020).
- National Records of Scotland. Available online: https://www.nrscotland.gov.uk/ (accessed on 28 December 2020).
- Scottish Index of Multiple Deprivation (SIMD). Available online: https://simd.scot/#/simd2020/BTTTFTT/9/-4.0000/55.9000/ (accessed on 28 December 2020).
- Murthy, V.; Bharia, G.; Sarin, R. Tamoxifen non-compliance: Does it matter? Lancet Oncol. 2002, 3, 654. [Google Scholar] [CrossRef]
- Wei, L.; Wang, J.; Thompson, P.; Wong, S.; Struthers, A.D.; Macdonald, T.M. Adherence to statin treatment and readmission of patients after myocardial infarction: A six year follow up study. Heart 2002, 88, 229–233. [Google Scholar] [CrossRef]
- Partridge, A.H.; Wang, P.S.; Winer, E.P.; Avorn, J. Non adherence to adjuvant tamoxifen therapy in women with primary breast cancer. J. Clin. Oncol. 2003, 21, 602–606. [Google Scholar] [CrossRef]
- Tunceli, K.; Iglay, K.; Zhao, C.; Brodovicz, K.G.; Radican, L. Factors associated with adherence to oral antihyperglycemic monotherapy in patients with type 2 diabetes mellitus in the United Kingdom. Diabetes Res. Clin. Pract. 2015, 109, e27–e31. [Google Scholar] [CrossRef] [PubMed]
- Donnan, P.T.; Macdonald, T.M.; Morris, A.D. Adherence to prescribed oral hypoglycaemic medication in a population of patients with Type 2 diabetes: A retrospective cohort study. Diabet. Med. 2002, 19, 279–284. [Google Scholar] [CrossRef]
- NHS Business Service Authority. (NHSB). Dispensing Data. Available online: https://www.nhsbsa.nhs.uk/prescription-data/dispensing-data (accessed on 28 December 2020).
- Baros, A.M.; Latham, P.K.; Moak, D.H.; Voronin, K.; Anton, R.F. What role does measuring medication compliance play in evaluating the efficacy of naltrexone? Alcohol. Clin. Exp. Res. 2007, 31, 596–603. [Google Scholar] [CrossRef] [PubMed]
- Donoghue, K.; Elzerbi, C.; Saunders, R.; Whittington, C.; Pilling, S.; Drummond, C. The efficacy of acamprosate and naltrexone in the treatment of alcohol dependence, Europe versus the rest of the world: A meta-analysis. Addiction 2015, 110, 920–930. [Google Scholar] [CrossRef][Green Version]
- Palpacuer, C.; Duprez, R.; Huneau, A.; Locher, C.; Boussageon, R.; Laviolle, B.; Naudet, F. Pharmacologically controlled drinking in the treatment of alcohol dependence or alcohol use disorders: A systematic review with direct and network meta-analyses on nalmefene, naltrexone, acamprosate, baclofen and topiramate. Addiction 2018, 113, 220–237. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Harris, A.H.; Oliva, E.; Bowe, T.; Humphreys, K.N.; Kivlahan, D.R.; Trafton, J.A. Pharmacotherapy of alcohol use disorders by the Veterans Health Administration: Patterns of receipt and persistence. Psychiatr. Serv. 2012, 63, 679–685. [Google Scholar] [CrossRef] [PubMed]
- Veluchamy, A.; Ballerini, L.; Vitart, V.; Schraut, K.E.; Kirin, M.; Campbell, H.; Joshi, P.K.; Relan, D.; Harris, S.; Brown, E.; et al. Novel Genetic Locus Influencing Retinal Venular Tortuosity Is Also Associated with Risk of Coronary Artery Disease. Arter. Thromb. Vasc. Biol. 2019, 39, 2542–2552. [Google Scholar] [CrossRef] [PubMed]
- Baldacchino, A.; O’Rourke, L.; Humphris, G. Investigating the effect of Alcohol Brief Interventions within accident and emergency departments using a data informatics methodology. Drug Alcohol Depend. 2018, 188, 47–52. [Google Scholar] [CrossRef] [PubMed]
- Weiss, R.D. Adherence to pharmacotherapy in patients with alcohol and opioid dependence. Addiction 2004, 99, 1382–1392. [Google Scholar] [CrossRef] [PubMed]
- Palmer, A.J.; Neeser, K.; Weiss, C.; Brandt, A.; Comte, S.; Fox, M. The long-term cost-effectiveness of improving alcohol abstinence with adjuvant acamprosate. Alcohol Alcohol. 2000, 35, 478–492. [Google Scholar] [CrossRef] [PubMed][Green Version]
|Ethnicity (white)||3319 (100%)|
|Mean age (SD) in years||48.41 (11.88)|
|1 most deprived||529 (16.0%)|
|6+ least deprived||1176 (35.5%)|
|Total number of deaths within the 10-year study period||617|
|Total number of Individuals who|
died within 1 year of starting acamprosate
|Overall attendance at hospitals||0.001|
|Mental and behavior disorder||0.919||0.642–1.317||0.7|
|Overall attendance at psychiatric hospitals||<0.001|
|Alcohol induced conditions: withdrawal, harmful use, dependence, hallucinations||3.734||1.79–7.8||<0.01|
|Mental and behavioral disorder due to use of alcohol||7.412||2.43–22.67||<0.01|
|Anxiety disorder, OCD, panic attack||647.3||181.93–2303.19||<0.001|
|Causes||ICD-10 Code||Examples||Number of Deaths within a 1-Year Period (%)|
|Alcohol liver disease||K70–K77||30 (33)|
|Mental and behavioral disorder due to use of alcohol||F10||53 (57)|
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Tolomeo, S.; Baldacchino, A. Adherence to Prescribed Acamprosate in Alcohol Dependence and 1-Year Morbidities and Mortality: Utilizing a Data Linkage Methodology. J. Clin. Med. 2021, 10, 2102. https://doi.org/10.3390/jcm10102102
Tolomeo S, Baldacchino A. Adherence to Prescribed Acamprosate in Alcohol Dependence and 1-Year Morbidities and Mortality: Utilizing a Data Linkage Methodology. Journal of Clinical Medicine. 2021; 10(10):2102. https://doi.org/10.3390/jcm10102102Chicago/Turabian Style
Tolomeo, Serenella, and Alex Baldacchino. 2021. "Adherence to Prescribed Acamprosate in Alcohol Dependence and 1-Year Morbidities and Mortality: Utilizing a Data Linkage Methodology" Journal of Clinical Medicine 10, no. 10: 2102. https://doi.org/10.3390/jcm10102102