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Monitoring of alcohol consumption in primary care among adults with bipolar disorder: A cross-sectional and retrospective cohort study.

Hardoon, SL; Khadjesari, Z; Nazareth, I; Hamilton, FL; Petersen, I; (2016) Monitoring of alcohol consumption in primary care among adults with bipolar disorder: A cross-sectional and retrospective cohort study. Journal of Affective Disorders , 198 pp. 83-87. 10.1016/j.jad.2016.03.019. Green open access

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Abstract

BACKGROUND: Screening for alcohol use disorders is an important priority in the healthcare of people with bipolar disorder, incentivised in UK primary care since 2011, through the Quality and Outcomes Framework (QOF). The extent of alcohol monitoring in primary care, and impact of QOF, is unknown. The aim was to examine recording of alcohol consumption in primary care. METHODS: Poisson regression of biennial alcohol recording rates between 2000 and 2013 among 14,051 adults with bipolar disorder and 90,023 adults without severe mental illness (SMI), from 484 general practices contributing to The Health Improvement Network UK-wide primary care database. RESULTS: Alcohol recording rates among people with bipolar disorder increased from 88.6 records per 1000 person-years (95% confidence interval 81.2-96.6) in 2000/2002 to 837.4 records per 1000 person-years (817.4-858.0) in 2011/2013; a more than nine-fold increase, mainly occurring after the introduction of the QOF incentive in 2011. In 2000/2002 alcohol recording levels among people with bipolar disorder were not statistically significantly different from those without SMI (adjusted rate ratio 0.96, 0.88-1.05). By 2011/2013, people with bipolar disorder were over four times as likely to have an alcohol record: adjusted rate ratio 4.45 (4.15-4.77). LIMITATIONS: The routinely collected data may be incomplete. Alcohol data entered as free-text was not captured. CONCLUSIONS: The marked rise in alcohol consumption recording highlights what can be achieved. It is most likely attributable to QOF, suggesting that QOF, or similar schemes, can be powerful tools in promoting aspects of healthcare.

Type: Article
Title: Monitoring of alcohol consumption in primary care among adults with bipolar disorder: A cross-sectional and retrospective cohort study.
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.jad.2016.03.019
Publisher version: http://dx.doi.org/10.1016/j.jad.2016.03.019
Language: English
Additional information: © 2016 Elsevier B.V. This manuscript is made available under a Creative Commons Attribution Non-commercial Non-derivative 4.0 International license (CC BY-NC-ND 4.0). This license allows you to share, copy, distribute and transmit the work for personal and non-commercial use providing author and publisher attribution is clearly stated. Further details about CC BY licenses are available at http://creativecommons.org/ licenses/by/4.0. Access may be initially restricted by the publisher.
Keywords: Alcohol, Bipolar disorder, Primary care, QOF, Screening
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/1478203
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