Alcohol and alcoholism : international journal of the Medical Council on Alcoholism
-
Alcoholic hepatitis (AH) and alcoholic cirrhosis disproportionately affect ethnic minority and safety-net populations. We evaluate the impact of a hospital's safety net burden (SNB) on in-hospital mortality and costs among patients with AH and alcoholic cirrhosis. ⋯ HBH hospitals predominantly serve ethnic minorities and underinsured/uninsured populations. The higher in-hospital mortality associated HBH particularly for alcoholic cirrhosis patients is alarming given its increasing burden in the USA.
-
We assessed the relationship between specialist and non-specialist admissions for alcohol withdrawal since the introduction of the UK government Health and Social Care Act in 2012. ⋯ The shift in demand from specialist to non-specialist alcohol admissions due to policy changes in England should be reversed by specialist workforce investment to improve outcomes. In the meantime, non-specialist services and staff must be resourced and equipped to meet the complex needs of these service users.
-
In view of the increase in the use of ethanol-containing hand sanitizers throughout the world due to the current COVID-19 pandemic, we wished to review the possible risks to patients treated with disulfiram, following a case report in which an apparent DER (disulfiram-ethanol reaction) was attributed to the cutaneous absorption of alcohol from hand sanitizers as well as by inhalation of vapour. ⋯ Warnings about absorption of alcohol through the skin from hand sanitizers and products such as perfumes, deodorants and after-shave (whose use is often warned against when disulfiram is prescribed) should be modified accordingly.
-
An updated Cochrane systematic review assessed effectiveness of screening and brief intervention to reduce hazardous or harmful alcohol consumption in general practice or emergency care settings. This paper summarises the implications of the review for clinicians. ⋯ Brief interventions can reduce harmful and hazardous alcohol consumption in men and women. Short, advice-based interventions may be as effective as extended, counselling-based interventions for patients with harmful levels of alcohol use who are presenting for the first time in a primary care setting.
-
Although shown to be effective, General Practitioners (GPs) tend to refuse the implementation of Screening and Brief Intervention (SBI). Their expectation of negative response by patients seems to contrast with the positive attitude towards SBI of these patients. This discrepancy may be resolved by regarding moderators such as drinking status and patient satisfaction. We hypothesized that the attitude towards SBI will be more positive for abstainers or low-level consumers in comparison to high risk consumers especially in case of low patient satisfaction. ⋯ SBI attitude of general practice patients depends on their drinking status: abstainers or low-level consumers revealed a more positive attitude towards SBI than risky consumers. This effect is moderated by the patient's satisfaction. Risky consumers show a more positive attitude towards SBI if they are satisfied with their GP.