Mental Health Comorbidities Among Patients With Chronic Medical Conditions and Alcohol Use Disorder

This work was sponsored by Alkermes, Inc. Introduction: Alcohol use disorder (AUD) is associated with greater rates of comorbid mental health disorders and increased burden of illness. Real-world data were used to characterize the burden of select mental health comorbidities among patients with ambulatory-care sensitive conditions (ACSCs) and comorbid AUD. Methods: This retrospective cohort study identified adults with moderate-to-severe AUD from patients with selected chronic conditions (CHF, CKD, asthma, diabetes, IBD, COPD, hypertension). Eligible patients had ≥1 inpatient, or ≥2 outpatient claims on separate days, with ≥1 year of continuous healthcare enrollment prior to diagnosis and 3 months after (MarketScan® Commercial and Medicare [1/1/2016–12/31/2020], Medicaid [1/1/2016–12/31/2019] claims databases). Results: Among 5,494,756 patients, 64,777 (1%) patients had comorbid AUD. Patients with AUD were more likely to be younger, male, enrolled in Medicaid, have other substance use disorders, and have higher rates of mental health comorbidities compared with patients without AUD. Major depressive disorder was the most common mental health comorbidity among patients with AUD across chronic conditions studied (range: 45%–56%). Bipolar disorder and schizophrenia were observed in 16%–29% and 5%–10% of patients with AUD, respectively. Interestingly, patients with asthma and comorbid AUD, while younger and healthier on average than AUD patients in other ACSC cohorts, had the highest burden of mental health comorbidities. Conclusion: In this real-world study, the presence of AUD in patients with select chronic conditions was associated with greater mental health burden, highlighting the importance of integrating AUD screening and treatment as part of a comprehensive plan of care. Sponsor: Alkermes, Inc.