How Secondary Interventions Reduce the Burden of Alcohol Consumption at Risk of Cirrhosis: A Public Health Decision-Making Model

IF 6 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Liver International Pub Date : 2025-04-01 DOI:10.1111/liv.70086

Claire Delacôte, Line Carolle Ntandja Wandji, Alexandre Louvet, Pierre Bauvin, Philippe Mathurin, Sylvie Deuffic-Burban

{"title":"How Secondary Interventions Reduce the Burden of Alcohol Consumption at Risk of Cirrhosis: A Public Health Decision-Making Model","authors":"Claire Delacôte, Line Carolle Ntandja Wandji, Alexandre Louvet, Pierre Bauvin, Philippe Mathurin, Sylvie Deuffic-Burban","doi":"10.1111/liv.70086","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Better understanding of the kinetics of the consumption of alcohol at risk of cirrhosis (≥ 20 g/day) and the prediction of the burden of alcohol consumption are needed for public health decision-making.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Based on individual data from 45 054 individuals, collected from the French Health, Health Care and Insurance Survey between 2002 and 2014, a Markov model was developed to predict the future burden of alcohol consumption ≥ 20 g/day. This estimated the incidence of alcohol intake with an intermediate (20–50 g/day) or high (≥ 50 g/day) risk of cirrhosis. The impact of five primary or secondary interventions was evaluated between 2024 and 2030.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A 1 L increase in per capita alcohol consumption was associated with a 7% increase in the risk of progression to 20–50 g/day and to ≥ 50 g/day (HR = 1.07, 95% CI 1.06–1.07). Female gender was associated with a lower risk (HR = 0.47, 95% CI 0.43–0.51) and age < 45 years with a higher risk (HR = 4.15, 95% CI 2.60–6.63) of consuming ≥ 50 g/day. In 2023, 2.5 million French individuals aged 15–74 years old drank ≥ 20 g/day (5.5%), and 435 000 of these drank ≥ 50 g/day. Based on the status quo (SQ), this prevalence would be 5.1% in 2030, and would not be influenced by primary prevention, but would be reduced by secondary interventions (from −2.0% to −13.7% compared to the SQ depending on the rate of implementation).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Primary interventions are important to reduce the overall impact of alcohol on health. The strategy of targeting individuals who already drink ≥ 20 g/day of alcohol is more effective in reducing the short-term burden of alcohol consumption at risk of cirrhosis than primary interventions. Thus, primary and secondary interventions need to be implemented jointly.</p>\n </section>\n </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 5","pages":""},"PeriodicalIF":6.0000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70086","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Liver International","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/liv.70086","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Better understanding of the kinetics of the consumption of alcohol at risk of cirrhosis (≥ 20 g/day) and the prediction of the burden of alcohol consumption are needed for public health decision-making.

Methods

Based on individual data from 45 054 individuals, collected from the French Health, Health Care and Insurance Survey between 2002 and 2014, a Markov model was developed to predict the future burden of alcohol consumption ≥ 20 g/day. This estimated the incidence of alcohol intake with an intermediate (20–50 g/day) or high (≥ 50 g/day) risk of cirrhosis. The impact of five primary or secondary interventions was evaluated between 2024 and 2030.

Results

A 1 L increase in per capita alcohol consumption was associated with a 7% increase in the risk of progression to 20–50 g/day and to ≥ 50 g/day (HR = 1.07, 95% CI 1.06–1.07). Female gender was associated with a lower risk (HR = 0.47, 95% CI 0.43–0.51) and age < 45 years with a higher risk (HR = 4.15, 95% CI 2.60–6.63) of consuming ≥ 50 g/day. In 2023, 2.5 million French individuals aged 15–74 years old drank ≥ 20 g/day (5.5%), and 435 000 of these drank ≥ 50 g/day. Based on the status quo (SQ), this prevalence would be 5.1% in 2030, and would not be influenced by primary prevention, but would be reduced by secondary interventions (from −2.0% to −13.7% compared to the SQ depending on the rate of implementation).

Conclusions

Primary interventions are important to reduce the overall impact of alcohol on health. The strategy of targeting individuals who already drink ≥ 20 g/day of alcohol is more effective in reducing the short-term burden of alcohol consumption at risk of cirrhosis than primary interventions. Thus, primary and secondary interventions need to be implemented jointly.

Abstract Image

查看原文本刊更多论文

二级干预如何减轻肝硬化风险中的酒精消费负担：一个公共卫生决策模型

背景更好地了解肝硬化风险（≥20g /天）饮酒动力学和预测饮酒负担是公共卫生决策的必要条件。方法基于2002年至2014年法国健康、医疗保健和保险调查中收集的45054人的个人数据，建立马尔可夫模型来预测饮酒量≥20 g/天的未来负担。该研究估计了中度（20 - 50g /天）或高（≥50g /天）肝硬化风险的酒精摄入量的发生率。在2024年至2030年期间评估了五种初级或二级干预措施的影响。结果：人均饮酒量每增加1升，进展至20-50 g/天和≥50 g/天的风险增加7% （HR = 1.07, 95% CI 1.06-1.07）。女性摄入≥50 g/天的风险较低（HR = 0.47, 95% CI 0.43-0.51），年龄和45岁的风险较高（HR = 4.15, 95% CI 2.60-6.63）。2023年，法国有250万15-74岁的人饮酒≥20g /天（5.5%），其中43.5万人饮酒≥50g /天。根据现状（SQ），到2030年，这一患病率将为5.1%，不会受到初级预防的影响，但会通过二级干预措施降低（与SQ相比，根据执行率从- 2.0%降至- 13.7%）。结论初级干预措施对于降低酒精对健康的总体影响非常重要。针对已经饮酒量≥20g /天的个体的策略在减少酒精消费的短期负担和肝硬化风险方面比初级干预措施更有效。因此，一级和二级干预措施需要联合实施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Liver International 医学-胃肠肝病学

CiteScore

13.90

自引率

4.50%

发文量

348

审稿时长

2 months

期刊介绍： Liver International promotes all aspects of the science of hepatology from basic research to applied clinical studies. Providing an international forum for the publication of high-quality original research in hepatology, it is an essential resource for everyone working on normal and abnormal structure and function in the liver and its constituent cells, including clinicians and basic scientists involved in the multi-disciplinary field of hepatology. The journal welcomes articles from all fields of hepatology, which may be published as original articles, brief definitive reports, reviews, mini-reviews, images in hepatology and letters to the Editor.