Hospital discharge location and socioeconomic deprivation as risk factors for alcohol dependence relapses: a cohort study

Manca, F. and Lewsey, J. (2021) Hospital discharge location and socioeconomic deprivation as risk factors for alcohol dependence relapses: a cohort study. Drug and Alcohol Dependence, 229(Part A), 109148. (doi: 10.1016/j.drugalcdep.2021.109148)

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Background: There is evidence that social support can improve the ability of an individual with alcohol use disorder to manage relapses. However, the role of families and friends in this context is debated as family history and co-drinking are also risk factors for initiating alcohol drinking or maintaining addictive behaviours. Aim: To quantitatively evaluate whether the hospital discharge location (in company or alone) after an alcohol dependence hospitalisation can influence the risk of relapses and whether this impact is modified by socioeconomic deprivation. Methods: A cohort of 1141 patients hospitalised for the first time for alcohol dependence in Scotland between 2010 and 2019 was derived from a routine healthcare database. Relapses were defined as recurrent alcohol-related hospitalisation. Survival analysis was undertaken to compare the risk of relapse for different discharge locations and socioeconomic deprivation groups. Results: On average, living in company of others was associated with a significant lower risk of relapses compared to living alone (HR: 0.84 95%CI: 0.71–0.99). This association differed across socioeconomic groups, being greater for those living in areas with the highest level of socioeconomic deprivation (HR: 0.76 95%CI: 0.57–1.01) and lower elsewhere. While this effect was not statistically significant (p = 0.056), its extent varied based on how we defined our cohort: it was not detectable when we expanded the cohort to all individuals with alcohol use disorders. Conclusion: Home settings and the environment where individuals reside should be considered as significant psychosocial factors when clinicians design therapies and hospital discharge planning for patients with alcohol dependence.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Lewsey, Professor Jim and Manca, Mr Francesco
Creator Roles:
Manca, F.Conceptualization, Data curation, Formal analysis, Visualization, Writing – original draft
Lewsey, J.Supervision, Formal analysis, Writing – review and editing
Authors: Manca, F., and Lewsey, J.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Health Economics and Health Technology Assessment
Journal Name:Drug and Alcohol Dependence
ISSN (Online):1879-0046
Published Online:29 October 2021
Copyright Holders:Copyright © 2021 Elsevier B.V.
First Published:First published in Drug and Alcohol Dependence 229(Part A): 109148
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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