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Record W4410332487 · doi:10.1111/ajad.70036

Treatment patterns and healthcare resource use among veterans initiating medication for incident moderate‐to‐severe alcohol use disorder

2025· article· en· W4410332487 on OpenAlex
Regina Grebla, Teresa L. Kauf, Angela Lax, Erin Cook, Yilu Lin, Jieruo Liu, Shuqian Liu, Amy K. O’Sullivan, Lizheng Shi, Sherry Shi, Maria A. Sullivan, Elyse Swallow, Katie Witkiewitz, Karen Drexler

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.

Bibliographic record

VenueAmerican Journal on Addictions · 2025
Typearticle
Languageen
FieldMedicine
TopicSubstance Abuse Treatment and Outcomes
Canadian institutionsGroup for Research in Decision Analysis
Fundersnot available
KeywordsAcamprosateNaltrexoneMedicineDiscontinuationDisulfiramAlcohol use disorderVeterans AffairsInternal medicinePsychiatryAlcoholPharmacology

Abstract

fetched live from OpenAlex

BACKGROUND AND OBJECTIVES: Several medications for alcohol use disorder (MAUDs) are recommended to treat alcohol use disorder (AUD) in the Veterans Affairs (VA) guidelines. This study descriptively characterized treatment patterns and healthcare resource utilization (HCRU) among VA patients with AUD treated with VA-recommended MAUDs. METHODS: Veterans Health Administration data (VHA; 08/01/2013-11/30/2019) were used to identify 31,384 adults aged ≥18 years with AUD who initiated disulfiram (n = 2115), acamprosate (n = 3756), oral naltrexone (n = 25,082), or extended-release naltrexone (XR-NTX; n = 431) following AUD diagnosis. Study measures, stratified by medication received, included treatment adherence (proportion of days covered), discontinuation, and HCRU over 1 year. RESULTS: Mean time to treatment discontinuation was high for all MAUDs but longest for XR-NTX (92 vs. 55-59 days; all p < .001). Relative to the year preceding AUD diagnosis, treatment with MAUDs was associated with fewer hospitalizations (XR-NTX: 0.48 vs. 0.42; oral naltrexone: 0.58 vs. 0.47; acamprosate: 0.67 vs. 0.60; disulfiram: 0.63 vs. 0.57) and more outpatient visits per patient (XR-NTX: 20.0 vs. 36.0; oral naltrexone: 19.0 vs. 30.0; acamprosate: 19.0 vs. 31.0; disulfiram: 17.0 vs. 29.0). CONCLUSION: Among veterans with AUD, this descriptive analysis found that MAUD use was associated with reduced hospitalizations, and XR-NTX was associated with a longer treatment duration versus oral MAUDs. SCIENTIFIC SIGNIFICANCE: This real-world study is among the first to describe clinical characteristics, treatment patterns, and HCRU in VHA patients who initiated MAUDs when all MAUDs were included in the VHA formulary.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.087
Threshold uncertainty score0.638

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.039
GPT teacher head0.334
Teacher spread0.295 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it