Drug and alcohol review最新文献

Introduction: We aimed to determine acceptability and feasibility of innovative wearable alcohol biosensor monitors (ABM) for patients with alcohol-related liver disease (ALD) and their clinicians.

Methods: Patients and clinicians at a tertiary care centre participated in qualitative interviews on usability, acceptability, feasibility, efficiency/effectiveness, impact of device on behaviour/clinical practice and preferences/barriers. Interviews were audiotaped, transcribed and coded using a constant comparison method for category themes.

Results: Patients (n = 23) were 56% female, mean 44 years old, 87% White, with moderate-severe liver disease. Some felt the ABMs appearance was unappealing; others felt it provided an opportunity for openness and education of others. While some found it feasible to wear, others felt it was unrealistic to wear 24/7. Importantly, there were many positive themes on effectiveness/efficiency-participants felt the ABM could better record their alcohol use and patterns of use than they could remember. Patients felt wearing the ABM motivated abstinence, gave accountability and was a source of security. Clinicians (n = 13) were mostly hepatologists (77%), seeing on average 38 ALD patients/month. Clinicians felt seeing patterns and amounts of alcohol use could inform clinical decision making and treatments but expressed concern over the volume and complexity of data.

Discussion and conclusions: Perspectives on ABMs for managing ALD were mixed among patients and providers. Future device designs may overcome acceptability barriers due to device appearance. However, for clinicians, the logistics of data gathering plus the complexity and volume of data produced by the ABM device requires considerable thought to make this an efficient tool for clinical use.

Clinicaltrials: gov identifier NCT03533660: Alcohol biosensor monitoring for alcohol liver disease.

Introduction: Alcohol health literacy is critical for informed consumer decision making but has yet received limited attention in public health research. We therefore seek to measure alcohol health literacy and its educational distribution in Germany.

Methods: In this cross-sectional study, we developed and applied a brief nine-item questionnaire on alcohol health literacy in an adult convenience sample (n = 391; February to April 2023). The association of educational attainment with 'insufficient' alcohol health literacy was tested in adjusted logistic regression models.

Results: Insufficient alcohol health literacy was recorded in 47.8% of men and 41.1% of women in our sample. While most respondents correctly identified common misconceptions and wrong beliefs about alcohol and were able to specify low-risk drinking limits for women and women during pregnancy, only few correctly identified all alcohol-related health conditions, especially respiratory and infectious diseases. Respondents with low education were 1.35 (risk ratio [RR], 95% confidence interval 1.09-1.50, p = 0.014) times more likely to have been classified as having insufficient alcohol health literacy than high-educated respondents. There was no statistically significant difference between respondents with medium versus high education (RR = 1.22, 95% confidence interval 0.99-1.43, p = 0.060).

Discussion and conclusions: Educational gaps in alcohol health literacy question a policy rationale that is fundamentally based on the premise of informed consumer choice. Strategies to raise alcohol health literacy must ensure that they reach all population groups, for instance, by providing health warning labels on alcohol containers.

Introduction: The aim of the study is to estimate the association between bar density and nighttime emergency calls to the police.

Methods: We used a pooled cross-sectional time-series data set covering the Swedish 290 municipalities spanning the time period 2012-2021. As outcome we used nighttime emergency calls to the police and daytime emergency calls to the police as control variable. Bar density was measured as number of serving establishments licensed to serve alcohol after 1 am. The municipalities were classified into three socio-economic (SES) categories: low, middle and high-SES areas. We used survey data to estimate the prevalence of heavy episodic drinking (HED) for each of the three SES areas. We applied fixed-effects modelling to estimate the association between bar density and nighttime police calls, implying that only within-unit variation was exploited.

Results: Findings suggested that a 10% increase in bar density would result in a 0.46% (p = 0.001) increase in nighttime police calls. There was a marked gradient in the bar effect across SES areas; in high-SES areas the effect was not significant, while the effect was twice as strong in the low-SES areas as in mid-SES areas. We also found that the lower the status of the SES area, the higher the prevalence of HED.

Discussion and conclusions: We found a significantly positive association between bar density and nighttime police calls. However, the association was markedly stronger in low-SES areas (which were also characterised by an elevated HED prevalence) than in high-SES areas (distinguished by a lower HED prevalence).

Introduction: Although integrated alcohol policies, characterised by being consistent, structurally connected and interdependent, are considered to be best practices, very few evaluations of such policies exist. We evaluated the impact of two phases of integrated alcohol policies implemented in Lithuania in 2008/2009 and 2017/2018 on adult (15+ years of age) alcohol per capita consumption.

Methods: Alcohol per capita consumption was the main outcome, based on national data from Statistics Lithuania. Time-series analyses using generalised additive mixed models were used, and unrecorded consumption trends were examined. A sensitivity analysis was conducted with data from the World Health Organization.

Results: The two phases of integrated alcohol policies were associated with average reductions in adult alcohol per capita consumption of almost 1 litre (-0.88 L; 95% confidence interval -1.43; -0.34). Sensitivity analyses with comparable international data on Lithuania yielded similar results.

Discussion and conclusions: Integrated alcohol policies had a substantial effect on the average level of consumption. However, the effect of major single policies for Lithuania and other Baltic countries has been estimated to be of about the same magnitude. We conclude that in order to be successful, integrated alcohol policies should include at least one major effective population-based policy.

Introduction: Sweden, with its history of restrictive alcohol policies and a large and diverse migrant population, constitutes an interesting context for studies on alcohol consumption patterns in migrant groups. This study examines how hazardous drinking among migrants in Sweden varies by origin, duration of residence and age at migration.

Methods: Pooled cross-sectional survey data from the Västra Götaland region of Sweden, collected in 2011 and 2015, were linked to register data containing demographic, socioeconomic and migration-related factors (i.e., country of birth, duration of residence, age at migration), for 7754 migrants and 68,493 Swedish-born individuals aged 18-84 years. Logistic regression analyses were applied to estimate odds ratios (OR) and 95% confidence intervals (CI) for hazardous drinking, identified by the validated Alcohol Use Disorders Identification Test.

Results: Relative to Swedish-born individuals, migrants from other Nordic countries had higher odds of hazardous drinking (OR 1.45, 95% CI 1.18-1.77), while migrants from other European (OR 0.55, 95% CI 0.44-0.69) and non-European (OR 0.25, 95% CI 0.20-0.31) countries showed lower likelihoods. Among non-Nordic migrants in particular, hazardous drinking was more common among those with a longer duration of residence and those who migrated at pre-school ages.

Discussion and conclusions: Hazardous drinking among non-Nordic migrants increasingly resembled that of the Swedish-born population over time, aligning with findings in less restrictive alcohol policy contexts. Understanding how drinking patterns vary among migrant groups over time and across policy contexts is essential for developing effective public health strategies to reduce hazardous consumption and associated health and social harms.

Ireland has regulated for all packaged alcohol products to include a health warning that states that 'there is a link between alcohol and fatal cancers'. This warning is being opposed in the World Trade Organization by 12 member states who are raising that the warning is an unnecessary barrier to trade. The World Health Organization is supporting Ireland. Countries should not oppose Ireland's warning which is defensible from legal and public health perspectives.