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Abstract
Aims. Alcohol use disorders (AUDs) are prevalent in Europe but occurrence in primary care and the proportion of treated cases are understudied. This study reports prevalence of AUDs and their treatment in European primary health care settings and compares them with general population estimates. Procedure. We sampled 358 general practitioners (GPs, refusal rate: 56.4%) across six European countries (Germany, Hungary, Italy, Latvia, Poland, and Spain) who assessed 13,003 patients including providing AUD diagnoses. A subsample of 8,476 patients (refusal rate: 17.8%) was interviewed subsequently, assessing DSM-IV AUD diagnoses via the Composite International Diagnostic Interview. Final AUD diagnoses combined GP and patient interview information. Findings. Past year AUDs were prevalent with 11.8% (95% CI: 11.2–12.5%) across all regions, which is 1.6 times the European general population AUD estimate. Of those diagnosed with AUDs, 17.7% (95% CI: 15.4–20.0%) received professional help. Compared to general population estimates, AUDs and their treatment were more prevalent in primary care settings in most countries, with disproportionally high AUD rates in Italy and Spain and unexpectedly low AUD rates in Hungary. Conclusions. We found higher prevalence and treatment rates of AUDs in primary health care compared to general population surveys, with large variability between the observed countries.
Funding
The study was financially supported by an investigator-initiated grant (grant number: 414209) to the last author and the GWT-TUD (Gesellschaft für Wissens- und Technologietransfer der TU Dresden mbh) by Lundbeck. The study sponsor has no role in study design; collection, analysis, and interpretation of data. The study sponsor also had no role in study design; collection, analysis, and interpretation of the data; writing of the report; and the decision to submit the paper for publication. The corresponding author confirms that all authors had full access to all the data in the study at all times, and had final responsibility for the decision to submit for publication. The corresponding author states that all authors are independent from the funding source.
Conflict of interest
AG: reports grants and personal fees from Lundbeck and D&A Pharma during the conduct of the study and grants from TEVA and personal fees from Abbivie outside the submitted work. AJ: reports personal fees and nonfinancial support from Lundbeck and nonfinancial support from Astra Zeneca, Sanofi Aventis, Polpharma, and Eli Lilly outside the submitted work. CP: no potential conflict of interest stated. JM: no potential conflict of interest stated. JR: reports grants from GWT-TUD during the conduct of the study and grants, personal fees, and being board member (Nalmefene) for Lundbeck outside the submitted work. MT: no potential conflict of interest stated. MW: reports personal fees from AOP Orphan, Berlin Chemie, Janssen, Lundbeck, D&A Pharma, Chiesi, Reckitt Benckiser, Sanofi Aventis, and Servier outside the submitted work. LP: no potential conflict of interest stated. PS: reports grants from University of Dresden during the conduct of the study and being primary care board member for Lundbeck outside the submitted work.
Ethics approval
This study was conducted according to the declaration of Helsinki. All procedures have been approved by local ethic boards, as specified in the following table:
Additional information
Funding
Notes on contributors
Jakob Manthey
JR, AG, and MW conceptualized the study and served as PI. All authors except CP, JM, and JR served as site PIs and organized and supervised fieldwork, and helped in data cleaning. CP, JM, and JR conceptualized the data analyses, helped in data cleaning and quality control, and conducted the quantitative and qualitative analyses. JM wrote a first draft of the paper, and all authors contributed to and approved of the final version.
Antoni Gual
JR, AG, and MW conceptualized the study and served as PI. All authors except CP, JM, and JR served as site PIs and organized and supervised fieldwork, and helped in data cleaning. CP, JM, and JR conceptualized the data analyses, helped in data cleaning and quality control, and conducted the quantitative and qualitative analyses. JM wrote a first draft of the paper, and all authors contributed to and approved of the final version.
Andrzej Jakubczyk
JR, AG, and MW conceptualized the study and served as PI. All authors except CP, JM, and JR served as site PIs and organized and supervised fieldwork, and helped in data cleaning. CP, JM, and JR conceptualized the data analyses, helped in data cleaning and quality control, and conducted the quantitative and qualitative analyses. JM wrote a first draft of the paper, and all authors contributed to and approved of the final version.
Lars Pieper
JR, AG, and MW conceptualized the study and served as PI. All authors except CP, JM, and JR served as site PIs and organized and supervised fieldwork, and helped in data cleaning. CP, JM, and JR conceptualized the data analyses, helped in data cleaning and quality control, and conducted the quantitative and qualitative analyses. JM wrote a first draft of the paper, and all authors contributed to and approved of the final version.
Charlotte Probst
JR, AG, and MW conceptualized the study and served as PI. All authors except CP, JM, and JR served as site PIs and organized and supervised fieldwork, and helped in data cleaning. CP, JM, and JR conceptualized the data analyses, helped in data cleaning and quality control, and conducted the quantitative and qualitative analyses. JM wrote a first draft of the paper, and all authors contributed to and approved of the final version.
Pierluigi Struzzo
JR, AG, and MW conceptualized the study and served as PI. All authors except CP, JM, and JR served as site PIs and organized and supervised fieldwork, and helped in data cleaning. CP, JM, and JR conceptualized the data analyses, helped in data cleaning and quality control, and conducted the quantitative and qualitative analyses. JM wrote a first draft of the paper, and all authors contributed to and approved of the final version.
Marcis Trapencieris
JR, AG, and MW conceptualized the study and served as PI. All authors except CP, JM, and JR served as site PIs and organized and supervised fieldwork, and helped in data cleaning. CP, JM, and JR conceptualized the data analyses, helped in data cleaning and quality control, and conducted the quantitative and qualitative analyses. JM wrote a first draft of the paper, and all authors contributed to and approved of the final version.
Marcin Wojnar
JR, AG, and MW conceptualized the study and served as PI. All authors except CP, JM, and JR served as site PIs and organized and supervised fieldwork, and helped in data cleaning. CP, JM, and JR conceptualized the data analyses, helped in data cleaning and quality control, and conducted the quantitative and qualitative analyses. JM wrote a first draft of the paper, and all authors contributed to and approved of the final version.
Jürgen Rehm
JR, AG, and MW conceptualized the study and served as PI. All authors except CP, JM, and JR served as site PIs and organized and supervised fieldwork, and helped in data cleaning. CP, JM, and JR conceptualized the data analyses, helped in data cleaning and quality control, and conducted the quantitative and qualitative analyses. JM wrote a first draft of the paper, and all authors contributed to and approved of the final version.