A Prospective Clinical Course Comparison of Patients With Alcohol Use Disorder Between Hospital and Community-Based Services in Korea

Objectives: Although alcohol use disorder (AUD) is a burdening public health problem, medical and community-based services are under-utilized in South Korea. To understand factors affecting the course of AUD, a nation-wide longitudinal follow-up study was conducted. Methods: A 3-year biannual follow-up evaluation of patients with AUD from six areas in South Korea was conducted in 2016-2019. Baseline demographic and clinical data, alcohol-related problems, affective symptoms, insight level, and motivation measures were compared between patients who failed and succeeded in cessation from heavy drinking (CHD) and between patients from medical (hospital) and community-based services. Results: The 6-month CHD rate was 18.3%-48.5%. After six months, follow-up loss and CHD were drastically decreased over time. AUD, alcohol craving, depression, and anxiety scale scores were higher in patients who failed CHD. Hospital patients showed higher AUD severity scores, whereas community patients showed higher depression scores. Failed CHD patients had greater AUD severity in medical setting and greater depression and anxiety severity in community setting. Conclusion: This study performed the first nation-wide prospective survey on the course of patients with AUD in South Korea. Difference in CHD rate and associated factors between medical and community settings in AUD treatment suggest a need for implementing treatment setting-specific programs.