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The Cochrane Database of Systematic... May 2023Harmful alcohol use is defined as unhealthy alcohol use that results in adverse physical, psychological, social, or societal consequences and is among the leading risk... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Harmful alcohol use is defined as unhealthy alcohol use that results in adverse physical, psychological, social, or societal consequences and is among the leading risk factors for disease, disability and premature mortality globally. The burden of harmful alcohol use is increasing in low- and middle-income countries (LMICs) and there remains a large unmet need for indicated prevention and treatment interventions to reduce harmful alcohol use in these settings. Evidence regarding which interventions are effective and feasible for addressing harmful and other patterns of unhealthy alcohol use in LMICs is limited, which contributes to this gap in services.
OBJECTIVES
To assess the efficacy and safety of psychosocial and pharmacologic treatment and indicated prevention interventions compared with control conditions (wait list, placebo, no treatment, standard care, or active control condition) aimed at reducing harmful alcohol use in LMICs.
SEARCH METHODS
We searched for randomized controlled trials (RCTs) indexed in the Cochrane Drugs and Alcohol Group (CDAG) Specialized Register, the Cochrane Clinical Register of Controlled Trials (CENTRAL) in the Cochrane Library, PubMed, Embase, PsycINFO, CINAHL, and the Latin American and Caribbean Health Sciences Literature (LILACS) through 12 December 2021. We searched clinicaltrials.gov, the World Health Organization International Clinical Trials Registry Platform, Web of Science, and Opengrey database to identify unpublished or ongoing studies. We searched the reference lists of included studies and relevant review articles for eligible studies.
SELECTION CRITERIA
All RCTs comparing an indicated prevention or treatment intervention (pharmacologic or psychosocial) versus a control condition for people with harmful alcohol use in LMICs were included.
DATA COLLECTION AND ANALYSIS
We used standard methodological procedures expected by Cochrane.
MAIN RESULTS
We included 66 RCTs with 17,626 participants. Sixty-two of these trials contributed to the meta-analysis. Sixty-three studies were conducted in middle-income countries (MICs), and the remaining three studies were conducted in low-income countries (LICs). Twenty-five trials exclusively enrolled participants with alcohol use disorder. The remaining 51 trials enrolled participants with harmful alcohol use, some of which included both cases of alcohol use disorder and people reporting hazardous alcohol use patterns that did not meet criteria for disorder. Fifty-two RCTs assessed the efficacy of psychosocial interventions; 27 were brief interventions primarily based on motivational interviewing and were compared to brief advice, information, or assessment only. We are uncertain whether a reduction in harmful alcohol use is attributable to brief interventions given the high levels of heterogeneity among included studies (Studies reporting continuous outcomes: Tau² = 0.15, Q =139.64, df =16, P<.001, I² = 89%, 3913 participants, 17 trials, very low certainty; Studies reporting dichotomous outcomes: Tau²=0.18, Q=58.26, df=3, P<.001, I² =95%, 1349 participants, 4 trials, very low certainty). The other types of psychosocial interventions included a range of therapeutic approaches such as behavioral risk reduction, cognitive-behavioral therapy, contingency management, rational emotive therapy, and relapse prevention. These interventions were most commonly compared to usual care involving varying combinations of psychoeducation, counseling, and pharmacotherapy. We are uncertain whether a reduction in harmful alcohol use is attributable to psychosocial treatments due to high levels of heterogeneity among included studies (Heterogeneity: Tau² = 1.15; Q = 444.32, df = 11, P<.001; I²=98%, 2106 participants, 12 trials, very low certainty). Eight trials compared combined pharmacologic and psychosocial interventions with placebo, psychosocial intervention alone, or another pharmacologic treatment. The active pharmacologic study conditions included disulfiram, naltrexone, ondansetron, or topiramate. The psychosocial components of these interventions included counseling, encouragement to attend Alcoholics Anonymous, motivational interviewing, brief cognitive-behavioral therapy, or other psychotherapy (not specified). Analysis of studies comparing a combined pharmacologic and psychosocial intervention to psychosocial intervention alone found that the combined approach may be associated with a greater reduction in harmful alcohol use (standardized mean difference (standardized mean difference (SMD))=-0.43, 95% confidence interval (CI): -0.61 to -0.24; 475 participants; 4 trials; low certainty). Four trials compared pharmacologic intervention alone with placebo and three with another pharmacotherapy. Drugs assessed were: acamprosate, amitriptyline, baclofen disulfiram, gabapentin, mirtazapine, and naltrexone. None of these trials evaluated the primary clinical outcome of interest, harmful alcohol use. Thirty-one trials reported rates of retention in the intervention. Meta-analyses revealed that rates of retention between study conditions did not differ in any of the comparisons (pharmacologic risk ratio (RR) = 1.13, 95% CI: 0.89 to 1.44, 247 participants, 3 trials, low certainty; pharmacologic in addition to psychosocial intervention: RR = 1.15, 95% CI: 0.95 to 1.40, 363 participants, 3 trials, moderate certainty). Due to high levels of heterogeneity, we did not calculate pooled estimates comparing retention in brief (Heterogeneity: Tau² = 0.00; Q = 172.59, df = 11, P<.001; I = 94%; 5380 participants; 12 trials, very low certainty) or other psychosocial interventions (Heterogeneity: Tau² = 0.01; Q = 34.07, df = 8, P<.001; I = 77%; 1664 participants; 9 trials, very low certainty). Two pharmacologic trials and three combined pharmacologic and psychosocial trials reported on side effects. These studies found more side effects attributable to amitriptyline relative to mirtazapine, naltrexone and topiramate relative to placebo, yet no differences in side effects between placebo and either acamprosate or ondansetron. Across all intervention types there was substantial risk of bias. Primary threats to validity included lack of blinding and differential/high rates of attrition.
AUTHORS' CONCLUSIONS
In LMICs there is low-certainty evidence supporting the efficacy of combined psychosocial and pharmacologic interventions on reducing harmful alcohol use relative to psychosocial interventions alone. There is insufficient evidence to determine the efficacy of pharmacologic or psychosocial interventions on reducing harmful alcohol use largely due to the substantial heterogeneity in outcomes, comparisons, and interventions that precluded pooling of these data in meta-analyses. The majority of studies are brief interventions, primarily among men, and using measures that have not been validated in the target population. Confidence in these results is reduced by the risk of bias and significant heterogeneity among studies as well as the heterogeneity of results on different outcome measures within studies. More evidence on the efficacy of pharmacologic interventions, specific types of psychosocial interventions are needed to increase the certainty of these results.
Topics: Humans; Male; Acamprosate; Alcoholism; Amitriptyline; Developing Countries; Disulfiram; Mirtazapine; Naltrexone; Ondansetron; Topiramate
PubMed: 37158538
DOI: 10.1002/14651858.CD013350.pub2 -
BMC Women's Health May 2023Alcohol abuse among women is a significant health problem. Consuming alcohol in high amounts causes decreased sexual stimulation, vaginal lubrication, dyspareunia, and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Alcohol abuse among women is a significant health problem. Consuming alcohol in high amounts causes decreased sexual stimulation, vaginal lubrication, dyspareunia, and difficulty reaching orgasm. Due to the different effects of alcohol consumption on sexual function, this study aimed to investigate the effect of alcohol consumption on sexual dysfunction in women.
METHODS
In this study, the researchers conducted a systematic search of several databases, including PubMed, Google Scholar, Scopus, Web of Science, Embase, and ScienceDirect, as well as the Google Scholar search engine, to identify studies reporting the impact of alcohol consumption on female sexual dysfunction. The search was conducted up until July 2022. A total of 225 articles were searched in the databases, and an additional 10 relevant articles were identified through manual search. After removing 93 articles due to duplication, 90 articles were excluded based on the study's inclusion and exclusion criteria. During the merit evaluation phase, 26 articles were excluded through the full-text study based on the study's inclusion and exclusion criteria, while 26 articles were excluded due to their low quality. Ultimately, only 7 studies were deemed suitable for the final evaluation. The analysis was conducted using a random effects model, while the heterogeneity of the studies was assessed using the I index. Data analysis was performed using the Comprehensive Meta-Analysis Version 2 software.
RESULTS
Based on the review of 7 studies involving a total sample size of 50,225 women and using the random effects method, the calculated odds ratio was 1.74 (95% CI: 1.006-3.04). This indicates that alcohol consumption increases the likelihood of sexual dysfunction in women by 74%. The Begg and Mazumdar rank correlation test, was used to analyze the distribution bias, but the results were not significant at the 0.1 significance level (p = 0.763).
CONCLUSION
The findings of this study demonstrate a significant correlation between alcohol consumption and an increased risk of sexual dysfunction in women. These results highlight the need for policymakers to prioritize this issue and raise awareness regarding the harmful effects of alcohol consumption on female sexual function and its impact on population health and reproduction.
Topics: Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological; Alcohol Drinking; Dyspareunia; Alcoholism
PubMed: 37131197
DOI: 10.1186/s12905-023-02400-5 -
Hepatology Communications May 2023Alcohol-associated liver disease (ALD) is a common cause of morbidity and premature mortality. To date, there has been no systematic synthesis of the prevalence of ALD.... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Alcohol-associated liver disease (ALD) is a common cause of morbidity and premature mortality. To date, there has been no systematic synthesis of the prevalence of ALD. This systematic review was done with the aim of reporting the prevalence of ALD across different health care settings.
METHODS
PubMed and EMBASE were searched for studies reporting the prevalence of ALD in populations subjected to a universal testing process. Single-proportion meta-analysis was performed to estimate the prevalence of all ALD, alcohol-associated fatty liver, and alcohol-associated cirrhosis, in unselected populations, primary care, and among patients with alcohol-use disorder (AUD).
RESULTS
Thirty-five studies were included reporting on 513,278 persons, including 5968 cases of ALD, 18,844 cases of alcohol-associated fatty liver, and 502 cases of alcohol-associated cirrhosis. In unselected populations, the prevalence of ALD was 3.5% (95% CI, 2.0%-6.0%), the prevalence in primary care was 2.6% (0.5%-11.7%), and the prevalence in groups with AUD was 51.0% (11.1%-89.3%). The prevalence of alcohol-associated cirrhosis was 0.3% (0.2%-0.4%) in general populations, 1.7% (0.3%-10.2%) in primary care, and 12.9% (4.3%-33.2%) in groups with AUD.
CONCLUSIONS
Liver disease or cirrhosis due to alcohol is not common in general populations and primary care but very common among patients with coexisting AUD. Targeted interventions for liver disease such as case finding will be more effective in at-risk populations.
Topics: Humans; Prevalence; Liver Diseases, Alcoholic; Liver Cirrhosis, Alcoholic; Liver Cirrhosis; Fatty Liver, Alcoholic; Alcoholism
PubMed: 37102767
DOI: 10.1097/HC9.0000000000000133 -
BMC Geriatrics Apr 2023High-risk alcohol use is an established modifiable risk factor for dementia. However, prior reviews have not addressed sex differences in alcohol-related dementia risk....
BACKGROUND
High-risk alcohol use is an established modifiable risk factor for dementia. However, prior reviews have not addressed sex differences in alcohol-related dementia risk. In this systematic review, we take a sex-specific perspective towards the alcohol-dementia link, taking into account the age of dementia onset.
METHODS
We searched electronic databases for original cohort or case-control studies investigating the association between alcohol use and dementia. Two restrictions were considered: First, studies had to report results stratified by sex. Second, given the fact that the age at dementia onset seems to affect the alcohol-dementia link, studies were required to distinguish between early-onset and late-onset dementia (cut-off: 65 years). Additionally, the contribution of alcohol to dementia incidence was quantified for a set of 33 European countries for the year 2019.
RESULTS
We reviewed 3,157 reports, of which 7 publications were finally included and summarised narratively. A lower dementia risk when drinking alcohol infrequent or at moderate levels was found in men (three studies) and women (four studies). High-risk use and alcohol use disorders increased the risk of mild cognitive impairment and dementia, particularly early-onset dementia. Estimating the alcohol-attributable share of incident dementia cases revealed that 3.2% and 7.8% of incident dementia cases were estimated to be attributable to high-risk alcohol use (at least 24 g of pure alcohol per day) in 45-to-64-year-old women and men, respectively.
CONCLUSIONS
Research to date has paid little attention to the sex-specific link of alcohol and dementia. In the absence of sex-specific research, the established recommendations on high-risk alcohol use should be employed to communicate the alcohol-attributable dementia risk.
Topics: Female; Humans; Male; Aged; Alcoholism; Dementia; Alcohol Drinking; Europe; Cognitive Dysfunction
PubMed: 37098501
DOI: 10.1186/s12877-023-03972-5 -
Genes & Nutrition Apr 2023The predominant source of alcohol in the diet is alcoholic beverages, including beer, wine, spirits and liquors, sweet wine, and ciders. Self-reported alcohol intakes... (Review)
Review
The predominant source of alcohol in the diet is alcoholic beverages, including beer, wine, spirits and liquors, sweet wine, and ciders. Self-reported alcohol intakes are likely to be influenced by measurement error, thus affecting the accuracy and precision of currently established epidemiological associations between alcohol itself, alcoholic beverage consumption, and health or disease. Therefore, a more objective assessment of alcohol intake would be very valuable, which may be established through biomarkers of food intake (BFIs). Several direct and indirect alcohol intake biomarkers have been proposed in forensic and clinical contexts to assess recent or longer-term intakes. Protocols for performing systematic reviews in this field, as well as for assessing the validity of candidate BFIs, have been developed within the Food Biomarker Alliance (FoodBAll) project. The aim of this systematic review is to list and validate biomarkers of ethanol intake per se excluding markers of abuse, but including biomarkers related to common categories of alcoholic beverages. Validation of the proposed candidate biomarker(s) for alcohol itself and for each alcoholic beverage was done according to the published guideline for biomarker reviews. In conclusion, common biomarkers of alcohol intake, e.g., as ethyl glucuronide, ethyl sulfate, fatty acid ethyl esters, and phosphatidyl ethanol, show considerable inter-individual response, especially at low to moderate intakes, and need further development and improved validation, while BFIs for beer and wine are highly promising and may help in more accurate intake assessments for these specific beverages.
PubMed: 37076809
DOI: 10.1186/s12263-023-00726-1 -
Medicine Apr 2023nonalcoholic fatty liver disease (NAFLD) is characterized by excessive accumulation of fat in the liver without alcoholism. We conducted a systematic review and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
nonalcoholic fatty liver disease (NAFLD) is characterized by excessive accumulation of fat in the liver without alcoholism. We conducted a systematic review and meta-analysis to elucidate the efficacy of aerobic exercise on metabolic indicators and physical performance of adult patients with NAFLD.
METHODS
To conduct the systematic review and network meta-analysis, 2 researchers searched PubMed, EBSCO, and Web of science databases to identify randomized clinical trials of aerobic exercise interventions for adults with NAFLD published between inception and July 2022. We assessed the methodological quality of the included literature using the Cochrane Risk Assessment Scale and the PEDro Scale. Relevant data were extracted, variables were converted to the same units, and meta-analysis was performed using RevMan 5.4 software. We compared mean differences (MD) between experimental and control groups. For each outcome analyzed, we expressed data as MD with 95% CI to compare metabolic markers and exercise capacity between the experimental and control NAFLD patients.
RESULTS
Eleven randomized clinical trials with a total of 491 individuals with NAFLD were included in accordance with the criteria of this study. Types of aerobic exercise include moderate or high-intensity interval running, cycling, Nordic walking, equipment training, etc; Training duration 4 to 16 weeks, 30 to 60 minutes 3 or more times a week. Compared with the control group, aerobic exercise group had reduced weight of patients, (MD) 1.20 kg (95% CI: -1.38 to -1.01 kg, P < .00001). Seven studies confirmed that aerobic exercise significantly reduced triglycerides, (MD) 3.00 mg/dL (95% CI: -5.80 to -0.21 mg/dL, P = .04); increased high density lipoproteins (MD) 5.96 mg/dL (95% CI: 2.95 to 8.96 mg/dL, P = .0001) and reduced low-density lipoproteins (MD) 6.45 mg/dL (95% CI: -8.53 to -4.37 mg/dL, P < .00001); the study also showed that aerobic exercise reduced the liver enzymes aspartate aminotransferase and alanine aminotransferase to varying degrees. Aerobic exercise can improve physical performance and increase peak oxygen consumption of (MD) 6.29 mL/Kg*minutes, (95% CI: 3.05-9.53mL/Kg*minutes, P = .0001).
CONCLUSION
Aerobic exercise significantly reduced weight and improved metabolic index and physical performance. Impacted by the limitations of various regimens, doses, duration, center settings, populations enrolled, the study had certain limitations. The randomized controlled trials with larger sample sizes, multiple centers, and high quality should be conducted to validate the above conclusion. Further studies will be required to focus on the total duration of the intervention, duration and frequency of sessions, and intensity that are optimal for the promotion of physical performance and metabolic capacity in this population.
Topics: Humans; Adult; Non-alcoholic Fatty Liver Disease; Network Meta-Analysis; Exercise; Exercise Therapy; Physical Functional Performance; Quality of Life; Randomized Controlled Trials as Topic
PubMed: 37026928
DOI: 10.1097/MD.0000000000033147 -
Drug and Alcohol Review Jul 2023Organisational factors have been found to be associated with health outcomes in a number of health-care settings. Despite likely being an important influence on the... (Review)
Review
INTRODUCTION
Organisational factors have been found to be associated with health outcomes in a number of health-care settings. Despite likely being an important influence on the quality of care provided within alcohol and other drug (AOD) treatment centres, the impact of organisational factors on AOD treatment outcomes have not been extensively explored. This systematic literature review examines the characteristics, methodological quality and findings of published studies exploring the association between organisational factors and client AOD treatment outcomes.
METHODS
Medline, Embase, PsycINFO and the Cochrane database were searched from 2010 to March 2022 for relevant papers. Studies meeting the inclusion criteria underwent quality assessment using the Joanna Brigg's Institute critical appraisal tool for cross-sectional studies, followed by data extraction of key variables pertaining to the aims. A narrative summary was used to synthesise the data.
RESULTS
Nine studies met the inclusion criteria. Organisational factors examined included cultural competency, organisational readiness for change, directorial leadership, continuity of care practices, service access, service to needs ratios, dual diagnosis training, therapeutic optimism and the funding model/health-care system that treatment was delivered in. Outcome measures included duration, completion or continuation of treatment; AOD use; and patient perceptions of treatment outcomes. Seven out of nine papers found a significant interaction between at least one organisational variable and AOD treatment outcomes.
DISCUSSION AND CONCLUSIONS
Organisational factors are likely to impact treatment outcomes for patients seeking treatment for AOD. Further examination of the organisational factors that influence AOD outcomes is needed to inform systemic improvements to AOD treatment.
Topics: Humans; Cross-Sectional Studies; Substance-Related Disorders; Treatment Outcome
PubMed: 37005012
DOI: 10.1111/dar.13653 -
The Lancet. Global Health May 2023Harm reduction and treatment programmes are essential for reducing harms for people who inject drugs (PWID). We aimed to update estimates from a 2017 review of global...
BACKGROUND
Harm reduction and treatment programmes are essential for reducing harms for people who inject drugs (PWID). We aimed to update estimates from a 2017 review of global coverage of needle and syringe exchange programmes (NSPs), opioid agonist treatment (OAT), and other harm reduction services that target PWID (eg, take-home naloxone [THN] programmes, supervised consumption facilities, and drug checking services).
METHODS
We did a systematic review of available evidence from peer-reviewed and grey literature databases for studies published between Jan 1, 2017, and May 31, 2022. Programmatic data were collected on the availability of services, the number of sites, people accessing services, and equipment distributed in countries where there is evidence of injecting drug use. National estimates of coverage of OAT (ie, number of people accessing OAT per 100 PWID) and NSPs (ie, number of needles and syringes distributed per PWID per year) were generated where available using the most recent data. Regional and global estimates were derived and compared with WHO indicators. The study was registered with PROSPERO (CRD42020173974).
FINDINGS
We included 195 studies and found there were 90 countries implementing OAT (75% of the PWID population) and 94 countries implementing NSPs (88% of the global PWID population). Only five countries (2% of the global PWID population) are providing high coverage of both services. Far fewer countries were implementing THN programmes (n=43), supervised consumption facilities (n=17), and drug checking services (n=26), with nine countries implementing all five services. Globally, we estimated there were 18 (95% uncertainty interval [UI] 12-27) people accessing OAT per 100 PWID, and 35 (95% UI 24-52) needles and syringes being distributed per person who injects drugs per year. More countries reported high (OAT 24; NSPs 10), moderate (OAT 8; NSPs 15), and low (OAT 38; NSPs 47) coverage of services compared with the previous review.
INTERPRETATION
Global coverage of OAT and NSPs has increased modestly in the past 5 years but remains low for most countries. Programmatic data on other key harm reduction interventions are scarce.
FUNDING
Australian National Health and Medical Research Council.
Topics: Humans; Substance Abuse, Intravenous; Drug Users; HIV Infections; Australia; Substance-Related Disorders; Harm Reduction
PubMed: 36996860
DOI: 10.1016/S2214-109X(23)00058-X -
The Lancet. Global Health May 2023People who inject drugs are exposed to various and changing risk environments and are at risk of multiple harms related to injecting drug use (IDU). We aimed to...
Epidemiology of injecting drug use, prevalence of injecting-related harm, and exposure to behavioural and environmental risks among people who inject drugs: a systematic review.
BACKGROUND
People who inject drugs are exposed to various and changing risk environments and are at risk of multiple harms related to injecting drug use (IDU). We aimed to undertake a global systematic review of the prevalence of IDU, key IDU-related harms (including HIV, hepatitis C virus [HCV], and hepatitis B virus [HBV] infection and overdose), and key sociodemographic characteristics and risk exposures for people who inject drugs.
METHODS
We systematically searched for data published between Jan 1, 2017, and March 31, 2022, in databases of peer-reviewed literature (MEDLINE, Embase, and PsycINFO) and grey literature as well as various agency or organisational websites, and disseminated data requests to international experts and agencies. We searched for data on the prevalence, characteristics, and risks of people who inject drugs, including gender, age, sexuality, drug-use patterns, HIV, HCV, and HBV infections, non-fatal overdose, depression, anxiety, and injecting-related disease. Additional data were extracted from studies identified in our previous review. Meta-analyses were used to pool the data where multiple estimates were available for a country. We present country, regional, and global estimates for each variable examined.
FINDINGS
We screened 40 427 reports published between 2017 and 2022, and the 871 eligible reports identified were added to the 1147 documents from the previous review. Evidence of IDU was documented in 190 of 207 countries and territories, and 14·8 million people (95% uncertainty interval [UI] 10·0-21·7) aged 15-64 years globally were estimated to inject drugs. Existing evidence suggests that there might be 2·8 million (95% UI 2·4-3·2) women and 12·1 million (95% UI 11·0-13·3) men who inject drugs globally, and that 0·4% (95% CI 0·3-1·3) of people who inject drugs identify as transgender. The amount of available data on key health and social risks among people who inject drugs varied widely across countries and regions. We estimated that 24·8% (95% CI 19·5-31·6) of people who inject drugs globally had experienced recent homelessness or unstable housing, 58·4% (95% CI 52·0-64·8) had a lifetime history of incarceration, and 14·9% (95% CI 8·1-24·3) had recently engaged in sex work, with substantial geographical variation. Injecting and sexual risk behaviour varied considerably geographically, as did risks of harms. Globally, we estimated that 15·2% (95% CI 10·3-20·9) of people who inject drugs are living with HIV, 38·8% (95% CI 31·4-46·9) have current HCV infection, 18·5% (95% CI 13·9-24·1) have recently overdosed, and 31·7% (95% CI 23·6-40·5) have had a recent skin or soft tissue infection.
INTERPRETATION
IDU is being identified in a growing number of countries and territories that comprise more than 99% of the global population. IDU-related health harms are common, and people who inject drugs continue to be exposed to multiple adverse risk environments. However, quantification of many of these exposure and harms is inadequate and must be improved to allow for better targeting of harm-reduction interventions for these risks.
FUNDING
Australian National Health and Medical Research Council.
Topics: Male; Humans; Female; Substance Abuse, Intravenous; Prevalence; Drug Users; Australia; Hepatitis C; Hepatitis B; Substance-Related Disorders; Hepacivirus; Hepatitis B virus; HIV Infections
PubMed: 36996857
DOI: 10.1016/S2214-109X(23)00057-8 -
Frontiers in Public Health 2023Alcohol use disorder is a medical condition characterized by an impaired ability to control or stop alcohol use despite adverse health outcomes. Despite several studies... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Alcohol use disorder is a medical condition characterized by an impaired ability to control or stop alcohol use despite adverse health outcomes. Despite several studies that have analyzed the prevalence and determinants, their results have been equivocal, and the reasons for the differences in prevalence rates and determinants of AUD across nationalities are unknown. Hence, this study estimated the pooled prevalence of alcohol use disorder and its determinant among adults in East Asian countries.
METHODS
Articles were searched from PubMed, Web of Science, EMBASE, PsycINFO, and Scopus. All observational study designs that fulfilled the predefined criteria were included in the study. The findings were reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). The quality and heterogeneity of articles were assessed using the new castle-Ottawa scale (NOS) and I, respectively. Additionally, publication bias was checked through funnel plot and Egger's regression test.
RESULTS
A total of 14 articles with 93, 161 study participants were considered in the study. Of which 9 studies were included in the meta-analysis of the 1-year prevalence of alcohol use disorder, 6 in the lifetime, 9 in alcohol abuse, and 8 in alcohol dependency. Consequently, the overall pooled prevalence of one-year alcohol use disorder was 8.88% (95% CI: 6.32, 11.44), lifetime 13.41% (95%CI: 8.48, 18.34), alcohol abuse 5.4% (95% CI: 2.66, 8.13), and alcohol dependency 4.47% (95% CI: 2.66, 6.27). In the subgroup analysis by country, the highest 1-year and lifetime pooled prevalence of alcohol use disorder was observed in Korea at 9.78% (95% CI:4.40, 15.15) and 16.73% (95% CI: 15.31, 18.16), respectively. Besides, smoking (OR: 3.99; 95% CI: 1.65, 6.33) and male gender (OR: 5.9; 95% CI: 3.3, 8.51) were significant determinants of alcohol use disorder.
CONCLUSIONS
The magnitude of alcohol use disorder was high among adults in East Asian countries. Smoking and male gender were the key determinants of alcohol use disorders.
Topics: Humans; Male; Adult; Alcoholism; East Asian People; Alcohol Drinking; Prevalence; Smoking; Observational Studies as Topic
PubMed: 36926176
DOI: 10.3389/fpubh.2023.1144012