| 1. |
- Carr, Sinclair, et al.
(författare)
-
Alcohol Consumption Levels and Health Care Utilization in Germany. Results from the GEDA 2014/2015-EHIS Study
- 2022
-
Ingår i: SUCHT. - : Hogrefe Publishing Group. - 0939-5911 .- 1664-2856. ; 68:3, s. 151-160
-
Tidskriftsartikel (refereegranskat)abstract
- Aims: Due to large inconsistencies in previous studies, it remains unclear how alcohol use is related to health care utilization. The aim of this study was to examine associations between alcohol drinking status with utilization of outpatient and inpatient health care services in Germany. Methodology: Survey data of the GEDA 2014/2015-EHIS study with n = 23,561 German adults were analyzed (response rate: 27 %). Respondents were categorized as lifetime abstainers, former drinkers, and non-weekly drinkers, as well as weekly low-risk drinkers and risky drinkers. Outpatient services included GP, specialist, and hospital visits; inpatient services included hospital overnight stays in the last 12 months. For both settings, binary logistic regression models were applied, adjusted for possible confounders. Results: For specialist visits, elevated odds were found among former drinkers (odds ratio (OR) = 1.93, 95 % confidence interval (95 % CI) = 1.50-2.49), non-weekly drinkers (OR = 1.24, 95 % CI = 1.05-1.47), weekly low-risk drinkers (OR = 1.39, 95 % CI = 1.17-1.67), and risky drinkers (OR = 1.28, 95 % CI = 1.04-1.57) compared to lifetime abstainers. In contrast, lower odds for inpatient service use were found among non-weekly drinkers (OR = 0.76, 95 % CI = 0.62-0.93), low-risk drinkers (OR = 0.66, 95 % CI = 0.53-0.81), and risky drinkers (OR = 0.65, 95 % CI = 0.51-0.84). No differences were observed for GP and outpatient hospital visits. Conclusions: While the increased odds of consulting a specialist are consistent with higher health care needs among former and current drinkers, the lower use of inpatient care among current drinkers is contrary to known health risks associated with alcohol consumption and evidence from hospitalized populations. The findings also highlight the need to differentiate between lifetime abstainers and former drinkers in their use of health services.
|
|
| 2. |
- Frischknecht, Ulrich, et al.
(författare)
-
Screening auf problematischen Alkoholkonsum – Erhebung zur Umsetzung der S3-Leitlinienempfehlungen in der transdisziplinären Versorgung einer Modellregion : [Screening for Problematic Alcohol Consumption – A Survey on Guideline Implementation in Transdisciplinary Health Care of a Model Region]
- 2022
-
Ingår i: Das Gesundheitswesen. - : Georg Thieme Verlag KG. - 0941-3790 .- 1439-4421. ; 84:01, s. 43-51
-
Tidskriftsartikel (refereegranskat)abstract
- Aim Recording the frequency of screenings for problematic alcohol consumption by professionals involved in the health care of respective patients. The German S3-guideline screening, diagnosis and treatment of alcohol-related disorders recommends the use of questionnaire-based screenings for all patients in all settings.Methods Cross-sectional survey on screening frequency among general practitioners, gynecologists, psychiatrists, child- and adolescent therapists, psychotherapists, social workers and midwives. Logistic regression was used to explore how healthcare professionals' attributes were associated with the implementation of screenings.Results With response rates of about 20%, health care professionals reported using screening instruments for an average of 6.9% of all patients during the previous four weeks. Most of the time, custom-made questions were used instead of the recommended instruments (AUDIT, AUDIT-C). Higher screening rates were reported for patients with newly diagnosed hypertension (21.2%), alcohol-related disorders (43.3%) and mental disorders (39.3%). Knowledge of the guideline was associated with implementation of screenings (OR=4.67; 95% KI 1.94-11.25, p<0.001).Conclusions Comprehensive screening for problematic alcohol use with questionnaire-based instruments in accordance with guidelines is far from being routinely implemented in the studied health care settings. Measures to increase the knowledge of the guidelines are necessary in order to increase the frequency of alcohol screening in health care.
|
|
| 3. |
- Hanschmidt, Franz, et al.
(författare)
-
Barriers to Alcohol Screening Among Hypertensive Patients and the Role of Stigma : Lessons for the Implementation of Screening and Brief Interventions in European Primary Care Settings
- 2017
-
Ingår i: Alcohol and Alcoholism. - : Oxford University Press (OUP). - 0735-0414 .- 1464-3502. ; 52:2, s. 572-579
-
Tidskriftsartikel (refereegranskat)abstract
- Aims1. To quantify barriers to alcohol screening among hypertensive patients reported by primary healthcare professionals. 2. To examine whether education and screening frequency measures are associated with stigma-related barriers.MethodsA web survey was conducted among 3081 primary healthcare professionals from France, Germany, Italy, Spain and the UK. Participants were asked about perceived barriers to alcohol screening as free-text response. The replies were independently categorized by two raters. Stigma-related barriers were predicted by logistic regressions with education, knowledge on alcohol as risk factor and frequency of alcohol screening.ResultsIn France and Italy, almost half of the reported barriers were stigma-related, whereas time constraints were cited most commonly in Spain and the UK. In Germany, nearly half of respondents rated the importance of alcohol screening for hypertension as low. Perception that regular screening is inappropriate or associated with too much effort, beliefs that screening is unnecessary, and insufficient knowledge of screening tools were cited as further barriers. Professional education on alcohol use was consistently rated to be poorer than the equivalent education on hypertension, and only a minority of respondents perceived alcohol as important risk factor for hypertension. Stigma-related barriers could not be significantly predicted by education, knowledge or screening frequency in most models.ConclusionsOverall, regular alcohol screening among hypertensive patients seems to be widely accepted, but further education (Germany) and structural support (Spain, UK) could contribute to increase screening rates. In France and Italy, screening uptake could be improved by addressing stigma.Short SummaryAlcohol screening among hypertensive patients was largely accepted among general practitioners from five different European countries. Reported screening barriers varied between countries and included time constraints, stigma and underrated importance of alcohol. Results did not indicate a positive impact of education and screening frequency on perception of stigma as barrier to screening.
|
|
| 4. |
- Kilian, Carolin, et al.
(författare)
-
A new perspective on European drinking cultures : a model-based approach to determine variations in drinking practices among 19 European countries
- 2021
-
Ingår i: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 116:8, s. 2016-2025
-
Tidskriftsartikel (refereegranskat)abstract
- Background and aims In recent decades, alcohol drinking in the European Union has been characterized by increasing homogenization of levels of drinking coupled with an overall decrease. This study examined whether we can still distinguish distinct practices of drinking by addressing two research questions: (1) are drinking practices still characterized by the choice of a certain alcoholic beverage; and (2) how do drinking practices vary across countries?Design Cross-sectional study: latent-class analyses of drinking variables and fractional response regression analyses of individual characteristics for individual-level class endorsement probabilities, respectively.Setting Nineteen European countries and one autonomous community.Participants A total of 27 170 past-year drinkers aged 18-65 years in 2015.Measurements Data were collected through the Standardized European Alcohol Survey included frequency of past-year drinking, pure alcohol intake per drink day, occurrence of monthly risky single-occasion drinking and preferred beverage, together with socio-demographic data.Findings Three latent classes were identified: (1) light to moderate drinking without risky single-occasion drinking [prevalence: 68.0%, 95% confidence interval (CI) = 66.7-69.3], (2) infrequent heavy drinking (prevalence: 12.6%, 95% CI = 11.5-13.7) and (3) regular drinking with at least monthly risky single-occasion drinking (prevalence: 19.4%, 95% CI = 18.1-20.9). Drinking classes differed considerably in beverage preference, with women reporting a generally higher share of wine and men of beer drinking. Light to moderate drinking without risky single-occasion drinking was the predominant drinking practice in all locations except for Lithuania, where infrequent heavy drinking (class 2) was equally popular. Socio-demographic factors and individual alcohol harm experiences (rapid alcohol on-line screen) explained up to 20.5% of the variability in class endorsement.Conclusions Beverage preference appears to remain a decisive indicator for distinguishing Europeans' drinking practices. In most European countries, multiple drinking practices appear to be present.
|
|
| 5. |
- Kilian, Carolin, et al.
(författare)
-
Alcohol Policy in Germany : Missed Opportunities to Lower Alcohol's Health Burden
- 2023
-
Ingår i: SUCHT. - 0939-5911 .- 1664-2856. ; 69:4, s. 163-171
-
Tidskriftsartikel (refereegranskat)abstract
- Upon the release of the third edition of the book Alcohol: no ordinary commodity, the authors evaluated the implementation of cost-effective alcohol policies in Germany. Method: Current legal regulations and practices addressing four policy areas were reviewed: (1) pricing and taxation policies; (2) regulating physical availability; (3) restrictions of alcohol marketing; and (4) drink-driving countermeasures. Results: Compared to other European countries, excise duties on alcoholic beverages and particularly on beer and wine are low and barely lower alcohol affordability. With few exceptions, alcoholic beverages can be purchased at any time and various retail venues (e. g., grocery stores, petrol stations). Restrictions on alcohol marketing are limited to youth protection and the portrayal of 'abusive' alcohol use. The recommended countermeasures to prevent driving under the influence of alcohol have been largely implemented. Conclusion: Cost-effective alcohol policies are insufficiently implemented in Germany, despite their potential to substantially lower the alcohol-related health burden.
|
|
| 6. |
- Kilian, Carolin, et al.
(författare)
-
Why Is Per Capita Consumption Underestimated in Alcohol Surveys? Results from 39 Surveys in 23 European Countries
- 2020
-
Ingår i: Alcohol and Alcoholism. - : Oxford University Press (OUP). - 0735-0414 .- 1464-3502. ; 55:5, s. 554-563
-
Tidskriftsartikel (refereegranskat)abstract
- Aims: The aims of the article are (a) to estimate coverage rates (i.e. the proportion of ‘real consumption’ accounted for by a survey compared with more reliable aggregate consumption data) of the total, the recorded and the beverage-specific annual per capita consumption in 23 European countries, and (b) to investigate differences between regions, and other factors which might be associated with low coverage (prevalence of heavy episodic drinking [HED], survey methodology).Methods: Survey data were derived from the Standardised European Alcohol Survey and Harmonising Alcohol-related Measures in European Surveys (number of surveys: 39, years of survey: 2008–2015, adults aged 20–64 years). Coverage rates were calculated at the aggregated level by dividing consumption estimates derived from the surveys by alcohol per capita estimates from a recent global modelling study. Fractional response regression models were used to examine the relative importance of the predictors.Results: Large variation in coverage across European countries was observed (average total coverage: 36.5, 95% confidence interval [CI] [33.2; 39.8]), with lowest coverage found for spirits consumption (26.3, 95% CI [21.4; 31.3]). Regarding the second aim, the prevalence of HED was associated with wine- and spirits-specific coverage, explaining 10% in the respective variance. However, neither the consideration of regions nor survey methodology explained much of the variance in coverage estimates, regardless of the scenario.Conclusion: The results reiterate that alcohol survey data should not be used to compare or estimate aggregate consumption levels, which may be better reflected by statistics on recorded or total per capita consumption.
|
|
| 7. |
- Kraus, Ludwig, et al.
(författare)
-
Alcohol screening and alcohol interventions among patients with hypertension in primary health care : an empirical survey of German general practitioners
- 2017
-
Ingår i: Addiction Research and Theory. - : Informa UK Limited. - 1606-6359 .- 1476-7392. ; 25:4, s. 285-292
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Alcohol is one of the least intervened risk factors in the management of hypertension at the primary care level. In order to improve alcohol interventions, a better understanding of knowledge, attitudes and clinical practice of lifestyle interventions in the management of hypertension is needed.Method: As a part of a European study (France, Germany, Italy, Spain, UK), 211 German general practitioners (GPs) were recruited in Bavaria and Hamburg and surveyed via an Internet-based questionnaire. Results were compared with the European sample (n=2870).Results: One-third of the patients seen by German GPs had hypertension (36.2%, standard deviation (SD): 14.6) and among cases with hypertension, less than half were ever screened for alcohol (4.5 out of 10 patients). The foremost reasons for not screening for alcohol were that alcohol was not considered a major risk factor for hypertension plus the lack of knowledge of appropriate alcohol screening instruments. The majority of German GPs managed patients with hazardous drinking levels themselves or in their practice (71.3%, 95% confidence interval (CI): 64.6-77.2%), but only 42.0% (95% CI: 35.2-49.0%) managed alcohol dependent patients. German screening rates were slightly lower but interventions of screened positive patients higher than the European average.Conclusions: Rates of alcohol screening in patients with hypertension in primary health care may be increased by improving GPs knowledge of alcohol as a major risk factor for hypertension, increasing GPs education on alcohol and screening instruments, and providing reimbursement. This may increase treatment of alcohol problems in patients with hypertension and reduce hypertension.
|
|
| 8. |
- Loy, Johanna K., et al.
(författare)
-
Changes in Alcoholic Beverage Choice and Risky Drinking among Adolescents in Europe 1999-2019
- 2021
-
Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:20
-
Tidskriftsartikel (refereegranskat)abstract
- This paper explores trends in beverage preference in adolescents, identifies related regional differences, and examines cluster differences in key drinking measures. Data were obtained from the European School Survey Project on Alcohol and Other Drugs (ESPAD), covering 24 European countries between 1999 and 2019. Trends in the distribution of alcoholic beverages on the participants’ most recent drinking occasion were analysed by sex and country using fractional multinomial logit regression. Clusters of countries based on trends and predicted beverage proportions were compared regarding the prevalence of drinkers, mean alcohol volume and prevalence of heavy drinking. Four distinct clusters each among girls and boys emerged. Among girls, there was not one type of beverage that was preferred across clusters, but the proportion of cider/alcopops strongly increased over time in most clusters. Among boys, the proportion of beer decreased, but was dominant across time in all clusters. Only northern European countries formed a geographically defined region with the highest prevalence of heavy drinking and average alcohol volume in both genders. Adolescent beverage preferences are associated with mean alcohol volume and heavy drinking at a country-level. Future approaches to drinking cultures need to take subpopulations such as adolescents into account.
|
|
| 9. |
- Manthey, Jakob, et al.
(författare)
-
Alcohol Use in Germany and Europe during the SARS-CoV-2 Pandemic
- 2020
-
Ingår i: SUCHT. - : Hogrefe Publishing Group. - 0939-5911 .- 1664-2856. ; 66:5, s. 247-258
-
Tidskriftsartikel (refereegranskat)abstract
- Aims: The aim of this study was to examine changes in alcohol consumption during the Sars-CoV-2 pandemic in Germany in comparison to changes in other European countries. Method: Analyses of sociodemographic and socio-economic data, as well as reports on alcohol use changes since the pandemic collected through a European online survey (N=40,064) in 21 countries. Weights based on gender, age and education were applied to account for sample bias. Results: Since the beginning of the pandemic, alcohol consumption has decreased on average. The decline is primarily due to a reduction in heavy episodic drinking occasions. As compared to other European countries, alcohol consumption in Germany has declined less sharply. This is mainly due to an increase in alcohol consumption among women as well as among people who report negative impacts on jobs and finances and among people with risky consumption patterns. Conclusion: In order to counter negative consequences of increased alcohol consumption in sub-groups during the pandemic, cutting the availability of alcohol through reasonable taxation and fostering alcohol screening activities in primary health care settings is needed.
|
|
| 10. |
- Manthey, Jakob, et al.
(författare)
-
Versorgung von Personen mit riskantem Alkoholkonsum und schwerer Alkoholkonsumstörung in Bremen : bedarfsgerecht und leitlinienkonform?
- 2020
-
Ingår i: Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz. - : Springer Science and Business Media LLC. - 1436-9990 .- 1437-1588. ; 63, s. 122-130
-
Tidskriftsartikel (refereegranskat)abstract
- Hintergrund: Riskanter Alkoholkonsum und schwere Alkoholkonsumstörungen sollten wegen gesundheitlichen Folgeschäden rechtzeitig erkannt werden. Die S3-Leitlinie „Screening, Diagnose und Behandlung alkoholbezogener Störungen“ empfiehlt daher die routinemäßige Anwendung von Screeningverfahren, z. B. in Allgemeinarztpraxen. Wird ein riskanter Konsum festgestellt, soll eine Kurzintervention erfolgen. Bei schwerer Alkoholkonsumstörung ist eine Entzugsbehandlung angezeigt, bei Komplikationsrisiken in stationärer Form.Ziel der Arbeit: Schätzung des Anteils von Personen mit riskantem Konsum und schwerer Alkoholkonsumstörung in leitlinienkonformer Versorgung im Bundesland Bremen.Material und Methoden: Die Prävalenz riskanten Konsums (weibl.: ≥12 g/Tag; männl.: ≥24 g/Tag) und schwerer Alkoholkonsumstörungen (weibl.: ≥60 g/Tag; männl.: ≥90 g/Tag) wurde über den Pro-Kopf-Konsum von Reinalkohol geschätzt. Behandlungsraten wurden auf Grundlage von Umfragedaten (für riskanten Konsum) sowie mittels Sekundärdaten vollstationärer Krankenhausaufenthalte (für schwere Alkoholkonsumstörung) geschätzt. Die Schätzungen beziehen sich auf die Bevölkerung ab 15 Jahre im Bundesland Bremen im Jahr 2016.Ergebnisse: Nur 2,9 % aller Personen mit riskantem Alkoholkonsum wurden durch ihre Hausärzt*innen gescreent; die Hälfte davon (1,4 %) erhielt eine Kurzintervention. 7,1 % der Personen mit einer schweren Alkoholkonsumstörung wurden vollstationär behandelt. Stationäre Entzugsbehandlungen wurden bei 14,1 % der Personen mit einer schweren Alkoholkonsumstörung durchgeführt, bei denen ein stationärer Entzug erforderlich ist. Unterdurchschnittliche Behandlungsraten wurden bei 21- bis 39-Jährigen registriert.Diskussion: Riskanter Konsum und schwere Alkoholkonsumstörungen sind in Bremen unzureichend versorgt, insbesondere bei 21- bis 39-Jährigen.
|
|
