Alcohol Use Hospitalizations in People with Gout, Osteoarthritis, Rheumatoid Arthritis, Fibromyalgia, and Low Back Pain Are Increasing: A Time-trends Study Using the U.S. National Data

Jasvinder Singh¹ and john Cleveland ², ¹University of Alabama Medical Center, Birmingham, ²University of Alabama at Birmingham, Birmingham, AL

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: alcohol use, fibromyalgia and rheumatoid arthritis (RA), gout, Health Care

Session Information

Date: Sunday, November 10, 2019

Title: Health Services Research Poster I – ACR/ARP

Session Type: Poster Session (Sunday)

Session Time: 9:00AM-11:00AM

Background/Purpose: Alcohol abuse and associated mortality is an important public health problem in the U.S. To our knowledge, limited data are available on alcohol use disorder-related hospitalizations in people with common musculoskeletal diseases.

Methods: We used the U.S. National Inpatient Sample (NIS) data from 1998-2014 to examine the rates of alcohol use disorder-related hospitalizations without overdose, detoxification or rehabilitation services, based on the presence of International Classification of Diseases, Ninth or Tenth Revision, Clinical Modification (ICD-9-CM or ICD-10-CM) diagnostic codes for alcohol dependence or abuse in the primary diagnosis position. We assessed five common rheumatic diseases using the respective diagnostic codes in a secondary position: Gout, rheumatoid arthritis (RA), fibromyalgia, osteoarthritis (OA), and low back pain (LBP). Incidence of alcohol use disorder claims was assessed per 100K NIS claims overall.

Results: The incidence of alcohol use disorder-related primary hospitalizations was low in 1998-2000 for the five musculoskeletal conditions and increased over the 19-year study period (Table1). The increase was 2-fold higher in people with gout, osteoarthritis or LBP, 2.5-fold for RA versus 3-fold higher in people with fibromyalgia. Rates of alcohol use disorder per 100K total NIS claims showed similar trends, with an increase ranging 3-fold in people with gout, osteoarthritis, LBP or RA to 4.5-fold in people with fibromyalgia (Table 2). There was a plateauing of alcohol use disorder claims for all conditions except osteoarthritis (Figure 1).

Conclusion: The rate of increase in alcohol use disorder hospitalizations occurred in all 5 musculoskeletal conditions, but the rate differed by the condition. Providers need to counsel their patients with these musculoskeletal conditions regarding the risk and impact of alcohol use, in order to prevent associated morbidity and mortality. Findings are also important for policy makers with regards to resource allocation.

Table1_Alcohol

Table 1. Number of alcohol use disorder as the primary reason for hospitalizations from 1998 to 2016 by five common musculoskeletal diseases

Table2_Alcohol

Table 2. Rate of alcohol use disorder primary hospitalizations from 1998 to 2016 per 100k total NIS claims by five common musculoskeletal diseases

Fig1_Alcohol

Figure 1. Trends in rates of primary alcohol abuse claims per 100K NIS claims, by five musculoskeletal conditions

Disclosure: J. Singh, Amarin pharmaceuticals, 1, 4, Clearview healthcae partners, 5, Clearview healthcare partners, 5, Clinical Care options, 5, Horizon, 5, Medisys, 5, OMERACT, 6, Putnam associates, 5, Spherix, 5, the American College of Rheumatology, 5, The American College of Rheumatology, 5, The National Institues of Health, 5, the National Institutes of Health, 5, Viking therapeutics, 1, 4, WebMD, 5; j. Cleveland, None.

To cite this abstract in AMA style:

Singh J, Cleveland j. Alcohol Use Hospitalizations in People with Gout, Osteoarthritis, Rheumatoid Arthritis, Fibromyalgia, and Low Back Pain Are Increasing: A Time-trends Study Using the U.S. National Data [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/alcohol-use-hospitalizations-in-people-with-gout-osteoarthritis-rheumatoid-arthritis-fibromyalgia-and-low-back-pain-are-increasing-a-time-trends-study-using-the-u-s-national-data/. Accessed .

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