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Low rates of prescribing alcohol relapse prevention medicines in Australian Aboriginal Community Controlled Health Services
Purcell-Khodr, Gemma C. Conigrave, James Lee, K. S. Kylie Vnuk, Julia Conigrave, Kate
Purcell-Khodr, Gemma C.
Conigrave, James
Lee, K. S. Kylie
Vnuk, Julia
Conigrave, Kate
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
Date
2023
Type
Journal article
Journal
Book
Volume
42
Issue
7
Page Range
1606-1616
Article Number
ACU Department
Institute for Positive Psychology and Education
Faculty of Education and Arts
Faculty of Education and Arts
Relation URI
Event URL
Open Access Status
Published as ‘gold’ (paid) open access
License
CC BY 4.0
File Access
Open
Notes
© 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.
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.