New AHRQ Resources Help Primary Care Clinicians Treat Alcohol Use Disorder
Press Release Date: February 16, 2016
The Agency for Healthcare Research and Quality (AHRQ) today published two new resources to help primary care clinicians and their patients make evidence-based decisions about which medications to use for treating alcohol use disorder (AUD), the medical diagnosis for problem drinking that causes mild to severe distress or harm.
The new resources—a pair of research summaries designed to facilitate treatment discussions between clinicians and patients—will make it easier for primary care clinicians to work with their patients to make treatment decisions about medications used to treat AUD. Primary care providers are typically trained to refer patients with AUD for specialized treatment, and fewer than 10 percent of people treated for AUD receive medications currently.
In the United States, more than 68 million people 18 years old or older suffer from AUD at some point in their lifetime, according to data released by the National Institute on Alcohol Abuse and Alcoholism in August 2015. The disorder can lead to severe health problems and immeasurable personal and family suffering. It is the third modifiable risk factor that leads to early death, after tobacco use and being overweight; people with AUD are at least three times as likely to die early as those without AUD.
"These new resources, based on the most current research, will help clinicians and patients make informed choices about treatment in accordance with their own wishes and values," said AHRQ Director Rick Kronick, Ph.D.
The research summaries are based on findings from a 2014 review of the evidence on medication-based treatment of AUD. One summary is directed at clinicians and other health care providers to help them understand the evidence currently available so they can apply it on the front lines of care. The other summary is written in a way that can help patients and their families understand what their options are for medication-based treatments.
AHRQ's systematic review found moderate evidence that acamprosate (trade name: Campral) and oral naltrexone (Reviva, Vivitrol) improve outcomes for patients with AUD. Head-to-head comparisons have not consistently established the superiority of one medication over another, and evidence related to injectable naltrexone is limited. The review also found that the evidence from randomized, placebo-controlled trials does not support the effectiveness of disulfiram (Antabuse) for clinical outcomes, such as a return to any drinking and number of drinks/per drinking days, or for reducing amount of alcohol consumed.
Most studies included in the review evaluated the use of medications in conjunction with psychosocial treatments; the use of medications alone has not been studied enough to draw conclusions, according to the review.
Conducted by researchers funded through AHRQ's Evidence-based Practice Center program, the review included studies on medicines to treat alcohol dependence and alcohol use disorder published between January 1970 and October 2013. The report included 135 studies, and findings were reviewed by health care professionals, researchers, experts and the public. The full report is available at https://effectivehealthcare.ahrq.gov/topics/alcohol-misuse-drug-therapy/policymaker
AHRQ's Evidence-based Practice Centers develop systematic reviews to help the public, clinicians and others who make decisions about health care improve the quality of care provided in the United States. These reviews provide comprehensive, science-based information on common, costly medical conditions and new health care technologies and strategies. Select findings from these reviews are translated into guides so that clinicians and patients can easily apply the findings on the front lines of care. These new AUD research summaries and other guides and systematic reviews can be found at www.effectivehealthcare.ahrq.gov.
AHRQ's mission is to produce evidence to make health care safer, higher quality, more accessible, equitable and affordable, and to work with Department of Health and Human Services and other partners to make sure that the evidence is understood and used. For more information about AHRQ, visit www.ahrq.gov.