The impact of alcohol‐specific conditions on multimorbidity prevalence: A systematic review and meta‐analysis

BACKGROUND AND AIMS: Multimorbidity, the presence of 2 or more long-term health conditions, and alcohol use disorders are both significant global concerns associated with poor health outcomes and substantial socioeconomic consequences, but their relationship remains under-explored. This study estimated the prevalence of multimorbidity among people with alcohol-specific conditions and compared it to those without alcohol-specific conditions. METHOD: Systematic review, searching six databases for cross-sectional, national surveys, cohort and case-control studies or randomised controlled trials that included a measurement of multimorbidity prevalence in adults with alcohol-specific conditions. The search included all settings (primary care, secondary care, community-based studies) without geographical limits, with data collected up to February 2026. Multimorbidity was defined as 1+ and/or 2+ long-term conditions in addition to alcohol-specific conditions (health conditions wholly attributable to alcohol consumption, as defined by standardised international classification systems). Studies measuring prevalence of individual co-morbidities only, using alcohol disorder screening tools, and those reporting only summary measures via a weighted index score, were excluded. The primary outcome was to estimate the absolute prevalence of multimorbidity in people with alcohol-specific conditions. Secondary outcomes were to compare the prevalence of multimorbidity between individuals with, and without, alcohol-specific conditions, and examine the impact of covariates (including age, sex, number and types of conditions assessed, geographical location, source of data and study quality). Study quality was assessed using adapted appraisal tools from the Joanna Briggs Institute. RESULTS: (estimating the percentage of variation due to heterogeneity rather than chance) = 99.99%]. The odds ratio (OR) of multimorbidity between those with and without alcohol-specific conditions at a threshold of at least two long-term conditions was 2.63 times greater (95% CI = 2.03-3.53, k = 15, P < 0.0001). Comparative prevalence was higher in younger populations with alcohol-specific conditions compared to without (<45 years old, OR = 3.41, 95% CI = 2.17-5.36) than in older populations (≥45 years old, OR = 1.83, 95% CI = 1.36-2.46). SUMMARY: Multimorbidity is common and disproportionately prevalent among people with alcohol-specific conditions, with particularly elevated odds of multimorbidity prevalence in younger cohorts.