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Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: Impact of minimum unit pricing on alcohol-related hospital outcomes: systematic review
Author(s): Maharaj, Tobias
Angus, Colin
Fitzgerald, Niamh
Allen, Kathryn
Stewart, Stephen
MacHale, Siobhan
Ryan, John D
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Keywords: General Medicine
Issue Date: Feb-2023
Date Deposited: 19-Feb-2024
Citation: Maharaj T, Angus C, Fitzgerald N, Allen K, Stewart S, MacHale S & Ryan JD (2023) Impact of minimum unit pricing on alcohol-related hospital outcomes: systematic review. <i>BMJ Open</i>, 13 (2), Art. No.: e065220.
Abstract: Objective: To determine the impact of minimum unit pricing (MUP) on the primary outcome of alcohol-related hospitalisation, and secondary outcomes of length of stay, hospital mortality and alcohol-related liver disease in hospital. Design: Databases MEDLINE, Embase, Scopus, APA Psycinfo, CINAHL Plus and Cochrane Reviews were searched from 1 January 2011 to 11 November 2022. Inclusion criteria were studies evaluating the impact of minimum pricing policies, and we excluded non-minimum pricing policies or studies without alcohol-related hospital outcomes. The Effective Public Health Practice Project tool was used to assess risk of bias, and the Bradford Hill Criteria were used to infer causality for outcome measures. Setting: MUP sets a legally required floor price per unit of alcohol and is estimated to reduce alcohol-attributable healthcare burden. Participant: All studies meeting inclusion criteria from any country Intervention: Minimum pricing policy of alcohol Results: 22 studies met inclusion criteria; 6 natural experiments and 16 modelling studies. Countries included Australia, Canada, England, Northern Ireland, Ireland, Scotland, South Africa and Wales. Modelling studies estimated that MUP could reduce alcohol-related admissions by 3%–10% annually and the majority of real-world studies demonstrated that acute alcohol-related admissions responded immediately and reduced by 2%–9%, and chronic alcohol-related admissions lagged by 2–3 years and reduced by 4%–9% annually. Minimum pricing could target the heaviest consumers from the most deprived groups who tend to be at greatest risk of alcohol harms, and in so doing has the potential to reduce health inequalities. Using the Bradford Hill Criteria, we inferred a ‘moderate-to-strong’ causal link that MUP could reduce alcohol-related hospitalisation. Conclusions: Natural studies were consistent with minimum pricing modelling studies and showed that this policy could reduce alcohol-related hospitalisation and health inequalities.
DOI Link: 10.1136/bmjopen-2022-065220
Rights: © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:
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