One in ten UK hospital inpatients is alcohol dependent

Peer reviewed: Yes
Type of study: Systematic Review
Subject of study: People
Funding: Government/research council

A new review of evidence from the UK has found high levels of alcohol dependence among hospital inpatients. The researchers estimate one in five patients in the UK hospital system uses alcohol harmfully, and one in ten is alcohol dependent.

Currently little is being done to screen routinely for alcohol dependence in hospitals, and services for patients with alcohol dependence are limited. The researchers call for universal screening in hospitals for alcohol-related problems and improved training for hospital staff around alcohol-related conditions.

This new systematic review and meta-analysis, published in the scientific journal Addiction, provides the first robust estimates of alcohol-related conditions among UK hospital inpatients by pooling the results of 124 earlier studies covering a total of 1,657,614 participants.

The prevalence of alcohol-related conditions was already thought to be higher in hospital inpatients compared with the general population, but until now we have not had reliable estimates of the true overall prevalence of these conditions in the inpatient population.  The review suggests harmful alcohol use is ten times higher in hospital inpatients, and alcohol dependence is eight times higher, compared with the UK general population.

The review also found that harmful use of alcohol is most prevalent in mental health inpatient units and alcohol dependence is found most commonly in patients attending accident and emergency departments.

Alcohol-related conditions are estimated to cost the National Health Service (NHS) approximately 3.5 billion pounds per year. Alcohol can cause a large number of medical conditions and without in-hospital screening many alcohol-related conditions may be missed and not receive appropriate treatment. Accurate prevalence estimates are vital to inform policy makers of the scale of the problem and are particularly timely given the UK government’s development of a new alcohol strategy and the NHS 10-year plan, which includes funding allocations to combat alcohol-related conditions.  

Lead researcher Dr Emmert Roberts, from the Institute of Psychiatry, Psychology & Neuroscience at King’s College London, says: ‘Many doctors are aware that alcohol-related conditions are common among hospital inpatients, but our results suggest the problem is much bigger than anecdotally assumed. Dedicated inpatient alcohol care teams are needed to ensure this widespread problem is being addressed, particularly in the context of diminishing numbers of specialist community alcohol services in the UK.’

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For editors:

This paper is free to download for one month after publication from the Wiley Online Library: https://onlinelibrary.wiley.com/doi/10.1111/add.14642 or by contacting Jean O’Reilly, Editorial Manager, Addiction, jean@addictionjournal.org, tel +44 (0)20 7848 0452.

To speak with lead author Dr Emmert Roberts, please contact: Robin Bisson, Senior Press Officer, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, robin.bisson@kcl.ac.uk / +44 20 7848 5377 / +44 7718 697176

Full citation for article: Roberts E, Morse R, Epstein S, Hotopf M, Leon D, and Drummond C (2019) The prevalence of wholly attributable alcohol conditions in the United Kingdom hospital system: A systematic review, meta-analysis and meta-regression.  Addiction 111: doi:10.1111/add.14642.

The study was funded by the lead author’s Medical Research Council Addiction Research Clinical (MARC) Fellowship.

Addiction is a monthly international scientific journal publishing peer-reviewed research reports on alcohol, substances, tobacco, and gambling as well as editorials and other debate pieces. Owned by the Society for the Study of Addiction, it has been in continuous publication since 1884. Addiction is the number one journal in the 2018 ISI Journal Citation Reports ranking in the substance abuse category (science edition).

About King’s College London and the Institute of Psychiatry, Psychology & Neuroscience 
King's College London is one of the top 10 UK universities in the world (QS World University Rankings, 2018/19) and is among the oldest universities in England.  The Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London is the premier centre for mental health and related neurosciences research in Europe. It produces more highly cited publications in psychiatry and mental health than any other university in the world (Scopus, 2016), with 21 of the most highly cited scientists in this field. World-leading research from the IoPPN has made, and continues to make, an impact on how we understand, prevent and treat mental illness and other conditions that affect the brain. www.kcl.ac.uk/ioppn