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Purchases of prescription drugs before an alcohol-related death: A ten-year follow-up study using linked routine data
University of Helsinki, Finland.ORCID iD: 0000-0002-5324-9825
Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. University of Helsinki, Finland; Max Planck Institute for Demographic Research, Germany; Karolinska Institutet, Sweden.ORCID iD: 0000-0001-9374-1438
University of Helsinki, Finland.
University of Helsinki, Finland.ORCID iD: 0000-0002-5184-644X
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2018 (English)In: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, Vol. 186, p. 175-181Article in journal (Refereed) Published
Abstract [en]

Background: Physician's intention to prescribe drugs could potentially be used to improve targeting of alcohol interventions and enhanced disease management to patients with a high risk of severe alcohol-related harm within outpatient settings. Methods: Comparison of ten-year incidence trajectories of 13.8 million reimbursed purchases of prescription drugs among 303,057 Finnish men and women of whom 7490 ultimately died due to alcohol-related causes (Ale+), 14,954 died without alcohol involvement (Alc-), and 280,613 survived until the end of 2007. Results: 5-10 years before death, 88% of the persons with an Alc+ death had received prescription medication, and over two-thirds (69%) had at least one reimbursed purchase of drugs for the alimentary tract and metabolism, the cardiovascular system, or the nervous system. Among persons with an Alc+ death, the incidence rate (IR) for purchases of hypnotics, and sedatives was L38 times higher (95% confidence interval (C1):1.32,1.44) compared to those with an Alc death, and 4.07 times higher (95%C1:3.92,4.22) compared to survivors; and the IR for purchases of anxiolytics was 1.40 times higher (95%Ck1.34,1.47) compared to those with an Ale death, and 3.61 times higher (95%C1:3.48,3.78) compared to survivors. Conclusions: Using physician's intention to prescribe drugs affecting the alimentary tract and metabolism, cardiovascular system and nervous system could potentially be used to flag patients who might benefit from screening, targeted interventions or enhanced disease management. In particular, patients who are to be prescribed anxiolytics, hypnotics, and sedatives, and antidepressants may benefit from enhanced interventions targeted to problem drinking.

Place, publisher, year, edition, pages
2018. Vol. 186, p. 175-181
Keywords [en]
Alcohol, Cohort study, Mortality, Outpatient, Prescription drugs, Problem drinking
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:su:diva-157795DOI: 10.1016/j.drugalcdep.2018.02.008ISI: 000432616400026PubMedID: 29597151OAI: oai:DiVA.org:su-157795DiVA, id: diva2:1235531
Available from: 2018-07-26 Created: 2018-07-26 Last updated: 2019-01-16Bibliographically approved

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Paljärvi, TapioMartikainen, PekkaVuori, ErkkiMäkelä, Pia
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