Screening and care for alcohol use disorder in France: expectations, barriers and levers using a mixed-methods approach

BMC Public Health

Patrizia Maria Carrieri¹  Marion Mora¹  Cyril Berenger¹  Marc Tanti¹  Marie Costa¹  Marion Coste¹  Perrine Roux¹  Tangui Barré¹  Gwenaelle Maradan¹  Issifou Yaya¹  Pierre Poloméni²  Marianne Maynard³  Christophe Cutarella⁴  Michaël Bazin⁵  Danielle Teuma⁶ 

[1] Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale;Assistance Publique, Hôpitaux de Paris;CRC Groupement Nord, Hôpital de la Croix Rousse;Clinique Saint-Barnabé;Unité d’addictologie, Centre Hospitalier d’Allauch;Unité d’addictologie, Hôpitaux du Bassin de Thau;

关键词: Alcohol use disorder;    Access to care;    Mixed-methods;    Survey;    Semi-structured interviews;    Textual analysis;   

DOI  :  10.1186/s12889-020-08495-x

来源: DOAJ

【 摘 要 】

Abstract Background The widespread under-screening and under-treatment of alcohol use disorder (AUD) contributes to its health and socioeconomic burden. We conducted a mixed-methods (qualitative and qualitative) study in people with alcohol use disorder (PWAUD) to explore their expectations, as well as barriers and levers to AUD care. Methods Individuals with AUDIT > 15 (N = 179) were interviewed using computer-assisted interviews in several medical and non-medical sites (e.g., bars) (quantitative substudy). We also conducted semi-structured face-to-face interviews with 36 PWAUD (qualitative substudy). Using logistic regression, we explored factors associated with having previously received/sought care for AUD. Three major themes were identified in the qualitative textual analysis using a descending hierarchical classification. Results Not socializing with heavy drinkers (AOR [95%CI]:3.84[1.66–8.85]), regular smoking (9.72[3.91–24.15]) and feeling discriminated against (2.35[1.10–5.05]) were independent levers to having sought/received care for AUD, while being aged < 50 and employment were independent barriers. The five predominant themes in PWAUD discourses emerging from the textual analysis were: drinking context, medical care, alcohol treatment, tobacco/addiction and family. When triangulating results from the logistic regression and the textual analysis, two barriers (social drinking and difficulties with the medical care system), and two levers (family influence and tobacco addiction), emerged. Conclusion These results underline the need for interventions targeting families and the social network to increase awareness about AUD and related care. Simplified and novel comprehensive care trajectories are urgently needed to reduce the clinical and public health burden of AUD.

【 授权许可】

Unknown