Socio‐economic differences in the effectiveness of pharmacotherapy use in alcohol use disorder: A cohort study of 148 626 individuals in Sweden.

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Bibliographic Details
Title: Socio‐economic differences in the effectiveness of pharmacotherapy use in alcohol use disorder: A cohort study of 148 626 individuals in Sweden.
Authors: Elling, Devy L., Thern, Emelie, Mangot‐Sala, Lluís, Tiihonen, Jari, Hammarberg, Anders, Falkstedt, Daniel, Taipale, Heidi
Source: Addiction. Mar2026, Vol. 121 Issue 3, p597-605. 9p.
Subjects: Patient compliance, Risk assessment, Research funding, Alcohol deterrents, Hospital care, Socioeconomic factors, Sex distribution, Patient readmissions, Treatment effectiveness, Descriptive statistics, Age distribution, Longitudinal method, Odds ratio, Acamprosate calcium, Drug efficacy, Alcoholism, Comparative studies, Data analysis software, Confidence intervals, Sociodemographic factors, Length of stay in hospitals, Regression analysis, Disulfiram, Naltrexone, Evaluation
Geographic Terms: Sweden
Abstract: Aim: To examine the socioeconomic differences in the effectiveness of alcohol use disorders (AUD) pharmacotherapy and risk of AUD hospitalisation. Design: A prospective register‐based cohort study. Setting: Sweden. Participants: Individuals who were registered as living in Sweden in 2005 (16–64 years) with a first‐time AUD diagnosis and complete information on their socioeconomic position (SEP) between 2005 and 2019 (n = 148 626). Measurement The outcome was AUD hospitalisation. The use of AUD pharmacotherapy was treated as a time‐varying exposure. SEP was the moderator. The association between the joint‐exposure (pharmacotherapy use and SEP) and AUD hospitalisation was assessed using a competing‐risk regression model, adjusted for sociodemographic factors, previous mental health diagnoses and use of other psychiatric medications. Findings Pharmacotherapy use was associated with a lower risk of AUD hospitalisation among high SEP individuals [subdistribution hazard ratio (SHR) = 0.83, 95% confidence interval (CI) = 0.77–0.90], but not among those with low SEP (SHR = 1.02, 95% CI = 0.94–1.10) and middle SEP (SHR = 1.01, 95% CI = 0.94–1.09), compared with low SEP individuals when not using pharmacotherapy. Conclusions: In Sweden, alcohol use disorder (AUD) pharmacotherapy appears to be effective to reduce the risk of AUD hospitalisation only among individuals of high socioeconomic position. [ABSTRACT FROM AUTHOR]
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Database: Psychology and Behavioral Sciences Collection
Description
Abstract:Aim: To examine the socioeconomic differences in the effectiveness of alcohol use disorders (AUD) pharmacotherapy and risk of AUD hospitalisation. Design: A prospective register‐based cohort study. Setting: Sweden. Participants: Individuals who were registered as living in Sweden in 2005 (16–64 years) with a first‐time AUD diagnosis and complete information on their socioeconomic position (SEP) between 2005 and 2019 (n = 148 626). Measurement The outcome was AUD hospitalisation. The use of AUD pharmacotherapy was treated as a time‐varying exposure. SEP was the moderator. The association between the joint‐exposure (pharmacotherapy use and SEP) and AUD hospitalisation was assessed using a competing‐risk regression model, adjusted for sociodemographic factors, previous mental health diagnoses and use of other psychiatric medications. Findings Pharmacotherapy use was associated with a lower risk of AUD hospitalisation among high SEP individuals [subdistribution hazard ratio (SHR) = 0.83, 95% confidence interval (CI) = 0.77–0.90], but not among those with low SEP (SHR = 1.02, 95% CI = 0.94–1.10) and middle SEP (SHR = 1.01, 95% CI = 0.94–1.09), compared with low SEP individuals when not using pharmacotherapy. Conclusions: In Sweden, alcohol use disorder (AUD) pharmacotherapy appears to be effective to reduce the risk of AUD hospitalisation only among individuals of high socioeconomic position. [ABSTRACT FROM AUTHOR]
ISSN:09652140
DOI:10.1111/add.70238