Impact of alcohol intake on medication adherence [abstract]

Does alcohol consumption impact medication adherence? I don’t know, but it’s a fair question. I would assume that it all depends on when you drink, how much, how often, if there’s any correlation between drinking time and medication consumption, age and social status of the patient, and so on. The variables one would have to look at would be quite extensive in my opinion. We’re talking about human behavior here, which is notoriously difficult to quantify and control.

The abstract below is from the October 2012 issue of the Journal of Studies on Alcohol and Drugs. It looks at the impact of alcohol consumption on medication adherence for chronic diseases like HIV, diabetes, hypertension, depression, among others. As expected the results are variable. The conclusion says it all: “Most studies reported negative effects of alcohol consumption on adherence, but evidence among non-HIV studies was less consistent.” Don’t read too much into that as more than three quarters of the studies reviewed were HIV/AIDS related, giving the researchers better information to work with. The other thing to note is that HIV/AIDS patients tend to receive a lot more one on one medication counseling from healthcare professionals than do patients with other disease states, i.e. they’re under closer scrutiny than say someone with hypertension.

To fully understand if alcohol consumption impacts medication adherence you’d have to follow several thousand people for an extended period of time. And even then you’d likely be able to punch holes in the data because of the number of variables involved.

Grodensky CA, Golin CE, Ochtera RD, Turner BJ. “Systematic review: effect of alcohol intake on adherence to outpatient medication regimens for chronic diseases.” J Stud Alcohol Drugs. 2012 Oct;73(6):899-910.

UNC Center for AIDS Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.


ABSTRACT. Objective: Nonadherence to medications can lead to adverse health outcomes. Alcohol consumption has been shown to be associated with nonadherence to antiretroviral medications, but this relationship has not been examined at different drinking levels or with other chronic disease medications. We conducted a narrative synthesis of the association of alcohol consumption with nonadherence to medications for four chronic diseases. Method: We searched MEDLINE, PsycINFO, Cochrane Library, and Web of Science for relevant studies published through 2009. To be included in this analysis, studies had to be quantitative; have a sample size of 50 or greater; and examine the effect of alcohol consumption on medication adherence for diabetes, hypertension, depression, or HIV/AIDS. Study characteristics and results were abstracted according to pre-specified criteria, and study quality was assessed. Study heterogeneity prevented a systematic synthesis. Results: Sixty eligible studies addressed medication adherence for HIV in 47 (78%), diabetes in 6 (10%), hypertension in 2 (3%), both diabetes and hypertension in 1 (2%), depression in 2 (3%), and all medications in 2 (3%). Mean number of subjects was 245 (range: 57-61,511). Effect sizes for the association of alcohol use with nonadherence varied (0.76-4.76). Six of the seven highest quality studies reported significant effect sizes (p < .05), ranging from 1.43 to 3.6. Most (67%) studies reporting multivariate analyses, but only half of non-HIV medicine studies, reported significant associations. Conclusions: Most studies reported negative effects of alcohol consumption on adherence, but evidence among non-HIV studies was less consistent. These data suggest the relevance of addressing alcohol use in improving antiretroviral adherence and a need for further rigorous study in non-HIV chronic diseases. (J. Stud.Alcohol Drugs, 73, 899-910, 2012).
PMID:23036207 [PubMed – in process]

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