Low rates of prescribing alcohol relapse prevention medicines in Australian Aboriginal Community Controlled Health Services
Journal article
Purcell-Khodr, Gemma C., Conigrave, James, Lee, K. S. Kylie, Vnuk, Julia and Conigrave, Kate. (2023). Low rates of prescribing alcohol relapse prevention medicines in Australian Aboriginal Community Controlled Health Services. Drug and Alcohol Review. 42(7), pp. 1606-1616. https://doi.org/10.1111/dar.13708
Authors | Purcell-Khodr, Gemma C., Conigrave, James, Lee, K. S. Kylie, Vnuk, Julia and Conigrave, Kate |
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Abstract | Introduction: Alcohol dependence is a chronic condition impacting millions of individuals worldwide. Safe and effective medicines to reduce relapse can be prescribed by general practitioners but are underutilised in the general Australian population. Prescription rates of these medicines to Aboriginal and Torres Strait Islander (First Nations) Australians in primary care are unknown. We assess these medicines in Aboriginal Community Controlled Health Services and identify factors associated with prescription. Methods: Baseline data (spanning 12 months) were used from a cluster randomised trial involving 22 Aboriginal Community Controlled Health Services. We describe the proportion of First Nations patients aged 15+ who were prescribed a relapse prevention medicine: naltrexone, acamprosate or disulfiram. We explore associations between receiving a prescription, a patient AUDIT-C score and demographics (gender, age, service remoteness) using logistic regression. Results: During the 12-month period, 52,678 patients attended the 22 services. Prescriptions were issued for 118 (0.2%) patients (acamprosate n = 62; naltrexone n = 58; disulfiram n = 2; combinations n = 4). Of the total patients, 1.6% were ‘likely dependent’ (AUDIT-C ≥ 9), of whom only 3.4% received prescriptions for these medicines. In contrast, 60.2% of those who received a prescription had no AUDIT-C score. In multivariate analysis, receiving a script (OR = 3.29, 95% CI 2.25–4.77) was predicted by AUDIT-C screening, male gender (OR = 2.24, 95% CI 1.55–3.29), middle age (35–54 years; OR = 14.41, 95% CI 5.99–47.31) and urban service (OR = 2.87, 95% CI 1.61–5.60). Discussion and Conclusions: Work is needed to increase the prescription of relapse prevention medicines when dependence is detected. Potential barriers to prescription and appropriate ways to overcome these need to be identified. |
Keywords | Aboriginal Community Controlled Health Services; alcohol dependence; alcohol use disorder; primary care; relapse prevention medicine |
Year | 01 Jan 2023 |
Journal | Drug and Alcohol Review |
Journal citation | 42 (7), pp. 1606-1616 |
Publisher | Wiley-Blackwell Publishing Ltd. (UK) |
ISSN | 0959-5236 |
Digital Object Identifier (DOI) | https://doi.org/10.1111/dar.13708 |
Web address (URL) | https://onlinelibrary.wiley.com/doi/10.1111/dar.13708 |
Open access | Open access |
Research or scholarly | Research |
Page range | 1606-1616 |
Publisher's version | License File Access Level Open |
Output status | Published |
Publication dates | |
Online | 09 Jul 2023 |
Publication process dates | |
Accepted | 12 Jun 2023 |
Deposited | 06 Aug 2024 |
Additional information | © 2023 The Authors. Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs. |
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. | |
Place of publication | United Kingdom |
https://acuresearchbank.acu.edu.au/item/90w1y/low-rates-of-prescribing-alcohol-relapse-prevention-medicines-in-australian-aboriginal-community-controlled-health-services
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Publisher's version
Conigrave_2023_Low_rates_of_prescribing_alcohol_relapse.pdf | |
License: CC BY 4.0 | |
File access level: Open |
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