Analysing Patient Trajectories of Individuals with Alcohol Use Disorders (PRAGMA)

Aim: Alcohol use is causing a considerable health burden for individuals and society in Germany. To reduce the burden from alcohol use, ensuring optimal treatment for those who are in need, is key. With this data-linkage study, we aim to provide a comprehensive description of healthcare service use among individuals with alcohol use disorders (AUD) in Hamburg, the second-largest German city. Methods: The study population is defined as adults living in Hamburg, currently insured by one of two statutory health insurance funds and with at least one alcohol-specific ICD-10 code between 2016 and 2021. Additionally, we will obtain data from pension funds and the Hamburg basic data monitoring system of outpatient addiction aid. By using unique identifiers, individual register data from these three sources will be linked. Hypotheses and qualitative analyses are presented in the form of research questions to analyse administrative prevalence rates, patient trajectories and predictors of treatment success as well as to estimate the impact of prototypical care pathways and the COVID-19 pandemic on utilization of alcohol-specific healthcare services. Discussion: The study 'Patient Routes of People with Alcohol Use Disorders in Germany' (PRAGMA) will be the first to provide an in-depth understanding of treatment provision for people with AUD in Germany. Following up a heterogeneous sample of people with AUD for six years will provide a unique opportunity to compare current with recommended care pathways as well to identify options for care improvements.