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Purchases of prescription drugs before an alcohol-related death: A ten-year follow-up study using linked routine data

Paljarvi, Tapio, Martikainen, Pekka, Leinonen, Taina, Vuori, Erkki and Mäkelä, Pia 2018. Purchases of prescription drugs before an alcohol-related death: A ten-year follow-up study using linked routine data. Drug and Alcohol Dependence 186 , pp. 175-181. 10.1016/j.drugalcdep.2018.02.008

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Abstract

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 (Alc+), 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 1.38 times higher (95% confidence interval (CI):1.32,1.44) compared to those with an Alc− death, and 4.07 times higher (95%CI:3.92,4.22) compared to survivors; and the IR for purchases of anxiolytics was 1.40 times higher (95%CI:1.34,1.47) compared to those with an Alc− death, and 3.61 times higher (95%CI: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.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Publisher: Elsevier
ISSN: 0376-8716
Date of First Compliant Deposit: 16 April 2018
Date of Acceptance: 20 February 2018
Last Modified: 28 Jun 2019 05:56
URI: http://orca.cf.ac.uk/id/eprint/110726

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