Secombe, Paul

Campbell, Lewis

Brown, Alex

Bailey, Michael

Pilcher, David

2021-04-23

AIMS: To describe the effect of alcohol policy on the incidence of intensive care unit (ICU) admissions associated with hazardous and harmful alcohol use in the Northern Territory (NT) of Australia DESIGN, SETTING AND PARTICIPANTS: Before and after analysis of admissions to NT ICUs between April 2018 and September 2019, extending on both a descriptive study describing hazardous and harmful alcohol use and single-centre analyses of harm minimization policies. After exclusions, 2281 (83%) admissions were analysed, 20.3% of which were associated with hazardous and harmful alcohol use. MEASUREMENTS: Primary outcome was the incidence of admissions associated with hazardous and harmful alcohol use in the 5 months preceding (baseline period) the introduction of new alcohol policies [full-time stationing of Police Auxiliary Liquor Inspectors (PALIs) and minimum unit price (MUP)] compared with 12 months (post-intervention) following. Secondary outcomes included measures of resource use [length of stay (LoS), need for mechanical ventilation] and mortality, stratified by site. FINDINGS: Overall, there was a 4.5% [95% confidence interval (CI) = 0.8-8.2%] absolute risk reduction between the time-periods (95% CI = 23.4 versus 18.9% for baseline and post-intervention, respectively, P = 0.01), predominantly due to a reduction in admissions associated with acute misuse (2.3%, 95% CI = -0.2 to 4.9% risk reduction, P = 0.06). There were regional differences, with a more marked relative risk reduction observed in Central Australia compared with the city of Darwin (27.0 versus 16.7% relative risk reduction, respectively). CONCLUSIONS: Introduction of new alcohol harm minimization policies in the Northern Territory of Australia appears to have reduced the number of intensive care unit admissions associated with hazardous and harmful alcohol use. Strength of effect varies by geographical region and chronicity of hazardous and harmful alcohol use.

Intensive Care Unit Alice Springs Hospital, Alice Springs, NT, Australia.

School of Medicine, Flinders University, Bedford Park, SA, Australia.

Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.

Australian and New Zealand Intensive Care Society Centre for Outcome and Resource Evaluation, Camberwell, VIC, Australia.

Intensive Care Unit, Royal Darwin Hospital, Darwin, NT, Australia.

Aboriginal Health Equity, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia.

Faculty of Health and Medical Sciences, University of Adelaide, Australia.

Department of Intensive Care, The Alfred Hospital, Prahran, Melbourne, VIC, Australia.

Addiction . 2021 Oct;116(10):2653-2662. doi: 10.1111/add.15432. Epub 2021 Apr 23.

0000-0002-1137-0512

0000-0003-4293-3258

0000-0003-2112-3918

0000-0002-5551-1401

0000-0002-8939-7985

https://pubmed.ncbi.nlm.nih.gov/33891373/?otool=iaurydwlib

https://hdl.handle.net/10137/11755

Hazardous and harmful alcohol use in the Northern Territory, Australia: the impact of alcohol policy on critical care admissions using an extended sampling period.

Journal Article

Publication