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Effectiveness of inpatient withdrawal and residential rehabilitation interventions for alcohol use disorder: A national observational, cohort study in England

Research output: Contribution to journalArticle

Brian Eastwood, Amy Peacock, Tim Millar, Andrew Jones, Jonathan Knight, Patrick Horgan, Tim Lowden, Peter Willey, John Marsden

Original languageEnglish
Pages (from-to)1-8
JournalJournal of Substance Abuse Treatment
Volume88
Early online date7 Feb 2018
DOIs
Publication statusPublished - May 2018

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Abstract

Background

This was a national English observational cohort study to estimate the effectiveness of inpatient withdrawal (IW) and residential rehabilitation (RR) interventions for alcohol use disorder (AUD) using administrative data.

Methods
All adults commencing IW and/or RR intervention for AUD between April 1, 2014 and March 31, 2015 reported to the National Drug Treatment Monitoring System (n = 3812). The primary outcome was successful completion of treatment within 12 months of commencement, with no re-presentation (SCNR) in the subsequent six months, analysed by multi-level, mixed effects, multivariable logistic regression.

Results

The majority (70%, n = 2682) received IW in their index treatment journey; one-quarter (24%, n = 915) received RR; 6% (n = 215) received both. Of treatment leavers, 59% achieved the SCNR outcome (IW: 57%; RR: 64%; IW/RR: 57%). Positive outcome for IW was associated with older age, being employed, and receiving community-based treatment prior to and subsequent to IW. Patients with housing problems were less likely to achieving the outcome. Positive outcome for RR was associated with paid employment, self/family/peer referral, longer duration of RR treatment, and community-based treatment following discharge. Community-based treatment prior to entering RR, and receiving IW during the same treatment journey as RR, were associated with lower likelihood of SCNR.

Conclusions

In this first national effectiveness study of AUD in the English public treatment system for alcohol-use disorders, 59% of patients successfully completed treatment within 12 months and did not represent for more treatment within six months. Longer duration of treatment and provision of structured continuing care is associated with better treatment outcomes.

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