OBJECTIVE Using electronic health record (EHR) data from a systematic, primary care-based alcohol screening, brief intervention, and referral to treatment (SBIRT) initiative within a health system, we examined correlates of remission from unhealthy drinking among patients with an alcohol use disorder (AUD). METHOD We conducted a longitudinal study of 4,078 adults with AUD who screened positive for unhealthy drinking between October 1, 2015, and September 30, 2016. We extracted EHR data up to 3 years after screening until October 1, 2018. We used survival analysis to examine associations between remission (i.e., reporting abstinence or low-risk drinking at a subsequent screening) and patient characteristics, comorbidities, and treatment utilization. RESULTS The median time to remission from unhealthy drinking was 1.7 years. Factors significantly associated with greater odds of remitting from unhealthy drinking during follow-up were female gender; older age (50-64 years); Black or Latino/Hispanic race/ethnicity; having more medical comorbidities; not having a comorbid drug use disorder; lower alcohol consumption levels; and receiving addiction medicine treatment before the index screening. In the first follow-up year, individuals with mental health comorbidities were more likely to remit, but those in psychiatric treatment were less likely. Receiving addiction treatment during follow-up was not associated with remission. CONCLUSIONS Ethnic minorities and individuals with mental illness were more likely to remit, which is encouraging given the health disparities observed among these clinically important subgroups and warrants further research. Our findings may inform research on AUD recovery and clinical practice, as remission from unhealthy drinking is a crucial component of the early stages of recovery.

中文翻译：

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饮酒障碍患者因不健康饮酒而缓解：一项基于系统的，基于初级保健的酒精筛查数据的纵向研究

目的使用健康系统中基于系统的，基于初级护理的酒精筛查，短暂干预以及转介治疗（SBIRT）计划的电子健康记录（EHR）数据，我们研究了饮酒患者中不健康饮酒缓解的相关性疾病（AUD）。方法我们对2015年10月1日至2016年9月30日期间筛查的不健康饮酒呈阳性的4078例AUD成年人进行了一项纵向研究。我们提取了筛查后长达3年的EHR数据，直至2018年10月1日。检查缓解（即在随后的筛查中报告戒酒或低危饮酒）与患者特征，合并症和治疗利用之间的关联。结果不健康饮酒后症状缓解的中位时间为1.7年。随访期间，与不健康饮酒导致排异的可能性更大相关的因素主要是女性。年龄较大（50-64岁）；黑人或拉丁裔/西班牙裔/种族；有更多的合并症；没有合并使用毒品的疾病；降低酒精消费水平；并在进行指标筛选之前接受成瘾药物治疗。在随访的第一年，患有精神疾病合并症的人更容易缓解，但是接受精神病治疗的人则不太可能。随访期间接受成瘾治疗与缓解无关。结论少数民族和患有精神疾病的人更容易患病，这是令人鼓舞的，因为在这些具有临床意义的亚组中观察到健康差异，有待进一步研究。