Outcomes from primary care management of alcohol dependence in France.
A prospective study assessed the outcome in a sample of 122 Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition alcohol-dependent patients in primary care. Standardized questionnaires collected clinical, social, and management data during 875 visits over an 18-month follow-up. A time-event analysis identified outcome predictors. Forty-three percent of patients attempted at least one detoxification during follow-up, one out of three in a hospital. Despite a very high relapse rate (83%), only 14% of the patients attempted a repeated abstinence. Longest and cumulative durations of abstinence appeared to be very close, corresponding to 29% of the follow-up time. The frequency of visits (risk ratio [RR] = 1.08) and visits addressing alcohol consumption (RR = 1.73) significantly lead to detoxification. In this French sample, management by the general practitioners appears to be a positive predictor of outcome in alcohol dependence. Future research could (a) enlighten the relationship between detoxification and frequency or circumstances of the visits and (b) tell whether formal planned follow-up by general practice physicians could improve outcome in alcohol dependence.
Malet
Laurent
L
CHU Clermont-Ferrand, Psychiatrie B, 57 rue Montalembert, Clermont-Ferrand 63000, France. lmalet@chu-clermontferrand.fr
Reynaud
Michel
M
Llorca
Pierre-Michel
PM
Chakroun
Nadia
N
Blanc
Olivier
O
Falissard
Bruno
B
D000328:Adult; D000437:Alcoholism / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010821:Physicians, Family; D010818:Practice Patterns, Physicians' / Q000458:organization & administration*; D011320:Primary Health Care / Q000379:methods*; D011446:Prospective Studies; D012008:Recurrence; D011795:Surveys and Questionnaires; D013695:Temperance; D016896:Treatment Outcome