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One in five UK hospital inpatients use alcohol harmfully

In the U.K., about one in five hospital inpatients used alcohol harmfully and one in 10 were alcohol-dependent, according to findings reported in Addiction.

“Alcohol is a potential causative factor for a plethora of conditions, and without dedicated in-hospital screening many alcohol-related conditions may be missed, and not receive appropriate treatment,” Emmert Roberts, MRCPsych, of the National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, and colleagues wrote. “The current evidence base is confused and contradictory, with a large range of differing prevalence estimates of alcohol-related conditions reported in the literature.”

To better estimate the prevalence of alcohol-related conditions in the U.K. hospital system, Roberts and colleagues conducted a systematic review and meta-analysis.

Researchers searched online clinical databases for studies reporting the prevalence of one of 26 wholly attributable alcohol conditions defined by the ICD-10 conducted in an in-patient setting (general wards, intensive care units, accident and EDs or mental health in-patient units). They pooled estimates using random-effects meta-analysis, then performed meta-regression to determine study and patient factors contributing to variation.

Overall, 124 studies encompassing 1,657,614 patients were included. Analysis revealed that most studies reported that inpatients used alcohol harmfully or were alcohol dependent, with a pooled prevalence of 19.76% (95% CI, 15.61-24.26) for harmful use and 10.25% (95% CI, 7.06-13.96) for dependence. However, both estimates were considered “very low” quality, according to the study.

Univariate meta-regression data indicated that mean age of patients explained 84% of the variation in the prevalence of harmful alcohol use and 100% of the variation in prevalence of alcohol dependence and that setting type explained 79.26% of the variation in harmful use prevalence and 60.84% of the variation in alcohol dependence prevalence. The investigators also reported that for every 1-year increase in the average age of patients the prevalence of harmful use dropped by 0.81% (95% CI, –1.19 to –0.44), and the prevalence of alcohol dependence dropped by 0.8% (95% CI, –1.36 to –0.24).

“Our data support the fact that hospital clinicians should be skilled in the diagnosis and management of alcohol-related conditions given their ubiquity in this setting,” Roberts and colleagues wrote. “Given the fact that hospital clinicians often report that they do not feel confident in the management of alcohol use disorders, our study adds to the evidence to support improved training concerning alcohol-related conditions. – by Savannah Demko

Disclosure: The authors report no relevant financial disclosures.