Trends and Inequalities in Prescribing for Alcohol Dependence in Scotland (TRIPADS).

More than 15,000 prescriptions are issued every month in Scotland to treat alcohol problems (‘AUDs’). However, high-quality evidence that these drugs are effective is very limited. Our study will address this by researching large national databases, without identifying individuals.

Clinical trials are well established as the best way to determine whether new treatments work. However, it is also known that such trial populations are often not representative of the general population (e.g. on average, younger and healthier). Our study avoids this problem by covering all patients in Scotland who have had a hospitalisation related to an alcohol problem. It also benefits from involving members of the public who will draw on their experience of alcohol treatment to inform direction and nature of the research.

Although there is guidance on what medications to use to help those who are dependent on alcohol to stop drinking initially, it is unclear how to treat people in the longer term to reduce their chances of drinking again, or how to treat other people who want to cut down, but not stop, drinking or who have had a severe alcohol-related hospital stay. In this study, we will research individuals prescribed medications for AUD, after a hospital stay related to AUD or alcohol dependence between 2010 and 2017. We will describe prescribing levels and how associated short-term health outcomes (alcohol-related hospital admissions and deaths) have changed over time and whether important variations exist, both in different health board areas, or for people of different ages, sex and socio-economic deprivation levels.

This research makes innovative use of national linked health records (prescribing, hospital stays, deaths). With the focus on identifying inequalities and involving the public to provide first-hand experience of alcohol treatment, our research is closely aligned with the research priority of ‘treatment and recovery today’.