Kirsten C Morley1, Warren Logge2, Sallie-Anne Pearson3, Andrew Baillie2, Paul S Haber4. 1. NHMRC Centre for Excellence in Mental Health and Substance Use, Sydney Medical School, The University of Sydney, NSW 2006, Australia. Electronic address: kirsten.morley@sydney.edu.au. 2. NHMRC Centre for Excellence in Mental Health and Substance Use, Macquarie University, NSW 2109, Australia. 3. Centre for Big Data Research in Health, UNSW, 2052, Australia. 4. NHMRC Centre for Excellence in Mental Health and Substance Use, Sydney Medical School, The University of Sydney, NSW 2006, Australia; Drug Health Services, Royal Prince Alfred Hospital, Camperdown, 2050 NSW, Australia.
Abstract
BACKGROUND: Although the efficacy of alcohol pharmacotherapy has been widely investigated, little is known about real-world prescription patterns. Population-based dispensing data can provide an understanding of prescription patterns and characteristics of treatment in nonexperimental settings. METHODS: A retrospective cohort study of patients (aged 15-84) treated with acamprosate or naltrexone between July 2009 and June 2013 was conducted using dispensing claims from the Australian Pharmaceutical benefits Scheme Database. Only individuals with prescriptions from September 2009 onwards were included. RESULTS: We identified 61,904 individuals (40% female, 32% in 35-44 age bracket,) with a total number of 198,247 dispensings. There were 23,452 naltrexone-treated and 38,452 acamprosate-treated patients. For naltrexone, 42% of initial dispenses were followed by a second dispense with only 25% receiving at least 3 months of treatment. For acamprosate, 28% of dispenses were followed by a third dispense with only 15% receiving at least 3 months of treatment. Patients in older age groups were more likely to be dispensed a repeat script than those in younger age groups (e.g., for the 75-84 vs 15-24 age bracket OR's=2.27 and 2.98 for naltrexone and acamprosate respectively). CONCLUSION: Current national guidelines in Australia recommend alcohol pharmacotherapy for a minimum period of 3 months yet only 15-25% are receive this duration of treatment. Naltrexone-treated patients were more likely to return for a second and third dispense than acamprosate-treated patients. Prevalence and prescribing patterns change with age. Crown
BACKGROUND: Although the efficacy of alcohol pharmacotherapy has been widely investigated, little is known about real-world prescription patterns. Population-based dispensing data can provide an understanding of prescription patterns and characteristics of treatment in nonexperimental settings. METHODS: A retrospective cohort study of patients (aged 15-84) treated with acamprosate or naltrexone between July 2009 and June 2013 was conducted using dispensing claims from the Australian Pharmaceutical benefits Scheme Database. Only individuals with prescriptions from September 2009 onwards were included. RESULTS: We identified 61,904 individuals (40% female, 32% in 35-44 age bracket,) with a total number of 198,247 dispensings. There were 23,452 naltrexone-treated and 38,452 acamprosate-treated patients. For naltrexone, 42% of initial dispenses were followed by a second dispense with only 25% receiving at least 3 months of treatment. For acamprosate, 28% of dispenses were followed by a third dispense with only 15% receiving at least 3 months of treatment. Patients in older age groups were more likely to be dispensed a repeat script than those in younger age groups (e.g., for the 75-84 vs 15-24 age bracket OR's=2.27 and 2.98 for naltrexone and acamprosate respectively). CONCLUSION: Current national guidelines in Australia recommend alcohol pharmacotherapy for a minimum period of 3 months yet only 15-25% are receive this duration of treatment. Naltrexone-treated patients were more likely to return for a second and third dispense than acamprosate-treated patients. Prevalence and prescribing patterns change with age. Crown
Authors: Louisa Degenhardt; Meyer Glantz; Sara Evans-Lacko; Ekaterina Sadikova; Nancy Sampson; Graham Thornicroft; Sergio Aguilar-Gaxiola; Ali Al-Hamzawi; Jordi Alonso; Laura Helena Andrade; Ronny Bruffaerts; Brendan Bunting; Evelyn J Bromet; José Miguel Caldas de Almeida; Giovanni de Girolamo; Silvia Florescu; Oye Gureje; Josep Maria Haro; Yueqin Huang; Aimee Karam; Elie G Karam; Andrzej Kiejna; Sing Lee; Jean-Pierre Lepine; Daphna Levinson; Maria Elena Medina-Mora; Yosikazu Nakamura; Fernando Navarro-Mateu; Beth-Ellen Pennell; José Posada-Villa; Kate Scott; Dan J Stein; Margreet Ten Have; Yolanda Torres; Zahari Zarkov; Somnath Chatterji; Ronald C Kessler Journal: World Psychiatry Date: 2017-10 Impact factor: 49.548
Authors: Augustin G L Vannier; Jessica E S Shay; Vladislav Fomin; Suraj J Patel; Esperance Schaefer; Russell P Goodman; Jay Luther Journal: JAMA Netw Open Date: 2022-05-02
Authors: Susan A Rombouts; James H Conigrave; Richard Saitz; Eva Louie; Paul Haber; Kirsten C Morley Journal: BMC Fam Pract Date: 2020-12-05 Impact factor: 2.497
Authors: Kristie H Harrison; Ks Kylie Lee; Timothy Dobbins; Scott Wilson; Noel Hayman; Rowena Ivers; Paul S Haber; James H Conigrave; David Johnson; Beth Hummerston; Dennis Gray; Katherine Conigrave Journal: BMJ Open Date: 2019-11-10 Impact factor: 2.692