Treatment patterns and healthcare resource use among veterans initiating medication for incident moderate-to-severe alcohol use disorder.

IF 2.5 4区医学 Q2 SUBSTANCE ABUSE

American Journal on Addictions Pub Date : 2025-05-12 DOI:10.1111/ajad.70036

Regina Grebla, Teresa L Kauf, Angela Lax, Erin E Cook, Yilu Lin, Jieruo Liu, Shuqian Liu, Amy K O'Sullivan, Lizheng Shi, Sherry Shi, Maria A Sullivan, Elyse Swallow, Katie Witkiewitz, Karen Drexler

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引用次数: 0

Abstract

Background and objectives: Several medications for alcohol use disorder (MAUDs) are recommended to treat alcohol use disorder (AUD) in the Veterans Affairs (VA) guidelines. This study descriptively characterized treatment patterns and healthcare resource utilization (HCRU) among VA patients with AUD treated with VA-recommended MAUDs.

Methods: Veterans Health Administration data (VHA; 08/01/2013-11/30/2019) were used to identify 31,384 adults aged ≥18 years with AUD who initiated disulfiram (n = 2115), acamprosate (n = 3756), oral naltrexone (n = 25,082), or extended-release naltrexone (XR-NTX; n = 431) following AUD diagnosis. Study measures, stratified by medication received, included treatment adherence (proportion of days covered), discontinuation, and HCRU over 1 year.

Results: Mean time to treatment discontinuation was high for all MAUDs but longest for XR-NTX (92 vs. 55-59 days; all p < .001). Relative to the year preceding AUD diagnosis, treatment with MAUDs was associated with fewer hospitalizations (XR-NTX: 0.48 vs. 0.42; oral naltrexone: 0.58 vs. 0.47; acamprosate: 0.67 vs. 0.60; disulfiram: 0.63 vs. 0.57) and more outpatient visits per patient (XR-NTX: 20.0 vs. 36.0; oral naltrexone: 19.0 vs. 30.0; acamprosate: 19.0 vs. 31.0; disulfiram: 17.0 vs. 29.0).

Conclusion: Among veterans with AUD, this descriptive analysis found that MAUD use was associated with reduced hospitalizations, and XR-NTX was associated with a longer treatment duration versus oral MAUDs.

Scientific significance: This real-world study is among the first to describe clinical characteristics, treatment patterns, and HCRU in VHA patients who initiated MAUDs when all MAUDs were included in the VHA formulary.

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中重度酒精使用障碍退伍军人的治疗模式和医疗资源使用

背景和目的：退伍军人事务（VA）指南中推荐几种治疗酒精使用障碍（AUD）的药物。本研究描述性地描述了接受VA推荐的maud治疗的VA患者的治疗模式和医疗资源利用率（HCRU）。方法：退伍军人健康管理局数据（VHA）；2013年1月8日- 2019年11月30日)，用于鉴别31,384名年龄≥18岁的AUD患者，他们服用了双硫仑（n = 2115）、阿坎前列酯（n = 3756）、口服纳曲酮（n = 25,082）或缓释纳曲酮(XR-NTX；n = 431)。研究措施按接受的药物分层，包括治疗依从性（覆盖天数的比例）、停药和1年内的HCRU。结果：所有mods的平均停药时间都很高，但XR-NTX的停药时间最长(92天vs. 55-59天；结论：在患有AUD的退伍军人中，这一描述性分析发现MAUD的使用与住院率降低有关，XR-NTX与口服MAUD相比，治疗持续时间更长。科学意义：这项真实世界的研究是第一个描述VHA患者的临床特征、治疗模式和HCRU的研究之一，当所有maud都包含在VHA处方中时，这些患者开始使用maud。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal on Addictions SUBSTANCE ABUSE-

CiteScore

5.00

自引率

0.00%

发文量

118

期刊介绍： The American Journal on Addictions is the official journal of the American Academy of Addiction Psychiatry. The Academy encourages research on the etiology, prevention, identification, and treatment of substance abuse; thus, the journal provides a forum for the dissemination of information in the extensive field of addiction. Each issue of this publication covers a wide variety of topics ranging from codependence to genetics, epidemiology to dual diagnostics, etiology to neuroscience, and much more. Features of the journal, all written by experts in the field, include special overview articles, clinical or basic research papers, clinical updates, and book reviews within the area of addictions.