A Rehabilitation out-Patient Clinic for Patients Discharged After Hepatic Encephalopathy Improves Survival

Andersen, Michala Maj; Aunt, Søren; Jensen, Nanna M.; Homann, Christian; Manniche, Joan; Svendsen, Svend; Christensen, Erik; Reher-Langberg, Astrid; Schiodt, Frank V.

doi:10.1016/s0016-5085(11)63882-1

Cited by 12 publications

(44 citation statements)

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“…We included 5 randomized controlled trials (RCTs) 21–25 and 8 non-randomized or observational studies (N = 2 non-randomized cohort studies with historical control groups 26, 27 and N = 6 uncontrolled studies using pre-post design 28–33 ) conducted in patients with CLD and HCV or ALD. We did not find any studies that included patients with CLD from other etiologies.…”

Section: Resultsmentioning

confidence: 99%

“…Two were non-randomized cohort studies with historical controls 26, 27 comparing supportive therapy and alcohol education to standard medical care (1 study 26 , N = 33 participants) and integrated CBT to supportive therapy (1 study 27 , N = 92 participants). The other 6 employed a pre-post design and examined CBT (2 studies 30, 32 , N=809), psychoeducation (2 studies 31, 33 , N=195 participants), combination therapy with MET, CBT and psychoeducation (1 study 28 , N=53 participants) and combination therapy with MET, CBT and MI (1 study 29 , N=47 participants).…”

Section: Resultsmentioning

confidence: 99%

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Efficacy of Psychosocial Interventions in Inducing and Maintaining Alcohol Abstinence in Patients With Chronic Liver Disease: A Systematic Review

Khan

Tansel

White

et al. 2016

Clinical Gastroenterology and Hepatology

135

113

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Background & Aims We conducted a systematic review of efficacy of psychosocial interventions in inducing or maintaining alcohol abstinence in patients with chronic liver disease (CLD) and alcohol use disorder (AUD). Methods We performed structured keyword searches in PubMed, PsychINFO, and MEDLINE for original research articles, published from January 1983 through November 2014, that evaluated the use of psychosocial interventions to induce or maintain alcohol abstinence in patients with CLD and AUD. Results We identified 13 eligible studies, comprising 1945 patients; 5 were randomized controlled trials (RCTs). Delivered therapies included motivational enhancement therapy (MET), cognitive behavioral therapy (CBT), motivational interviewing (MI), supportive therapy and psychoeducation either alone or in combination in the intervention group and general health education or treatment as usual in the control group. All studies of induction of abstinence (4 RCTs and 6 observational studies) reported an increase in abstinence among participants in the intervention and control groups. Only an integrated therapy that combined CBT and MET with comprehensive medical care, delivered over 2 years, produced a significant increase in abstinence (74% increase in intervention group versus 48% increase in control group; P=.02), reported in 1 RCT. All studies of maintenance of abstinence (1 RCT and 2 observational studies) observed recidivism in the intervention and control groups. Only an integrated therapy that combined medical care with CBT produced a significantly smaller rate of recidivism (32.7% in integrated CBT group versus 75% decrease in control group, P=.03), reported from 1 observational study. However, data were not collected for more than 2 y on outcomes of patients with CLD and AUD. Conclusion In a systematic analysis of studies of interventions to induce or maintain alcohol abstinence in patients with CLD and AUD, integrated combination psychotherapy with CBT, motivational enhancement therapy, and comprehensive medical care increased alcohol abstinence. No psychosocial intervention was successful in maintaining abstinence, but an integrated therapy with CBT and medical care appears to reduce recidivism.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Efficacy of Psychosocial Interventions in Inducing and Maintaining Alcohol Abstinence in Patients With Chronic Liver Disease: A Systematic Review

Khan

Tansel

White

et al. 2016

Clinical Gastroenterology and Hepatology

135

113

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“…Andersen et al (2013) found that patients who have survived HE and are connected to a cirrhosis clinic reduce their alcohol intake and have increased survival rates. This study adds that the ALD patients have a fear of a recurrence of their disease and find the cirrhosis clinic to be a safety net, monitoring their body to prevent the illness and thereby providing a feeling of security.…”

Section: Discussionmentioning

confidence: 99%

“…Andersen et al found that survival was significantly improved in 19 ALD patients who received treatment in an out-patient rehabilitation clinic compared to 14 patients who did not attended after HE. The treatment consists of a one-hour session within one to three weeks of discharge and involves the identification of clinical, psychological and social problems (Andersen et al 2013). These studies indicated that ALD patients can benefit from rehabilitation programmes in terms of gaining knowledge of and support in coping and lifestyle change.…”

Section: Introductionmentioning

confidence: 99%

“…We conducted a controlled intervention study consisting of interviews with ALD patients who survived HE and a CPR intervention in a hospital setting as a supplement to a one-hour session that involved the recording of physical parameters and identification of clinical, psychological and social problems (Andersen et al 2013). Every three weeks for six months, the patients visited a cirrhosis clinic.…”

Section: Introductionmentioning

confidence: 99%

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Alcoholic liver disease patients’ perspective of a coping and physical activity‐oriented rehabilitation intervention after hepatic encephalopathy

Mikkelsen

Hendriksen

Schiødt

et al. 2016

Journal of Clinical Nursing

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A coping and physical activity-oriented rehabilitation intervention may help alcoholic liver disease patients to regain control over their diseased body and give patients the experience of togetherness, self-control and physical strength. Professionals should be aware of giving the patients the experience of togetherness in their interactions, help them perceive self-control and gain physical strength during their rehabilitation.

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What Is the ethical (Not Legal) responsibility of a physician to treat minimal hepatic encephalopathy and advise patients not to drive?

Lauridsen

Wade

Bajaj

2015

Clinical Liver Disease

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A Rehabilitation out-Patient Clinic for Patients Discharged After Hepatic Encephalopathy Improves Survival

Cited by 12 publications

References 0 publications

Efficacy of Psychosocial Interventions in Inducing and Maintaining Alcohol Abstinence in Patients With Chronic Liver Disease: A Systematic Review

Efficacy of Psychosocial Interventions in Inducing and Maintaining Alcohol Abstinence in Patients With Chronic Liver Disease: A Systematic Review

Alcoholic liver disease patients’ perspective of a coping and physical activity‐oriented rehabilitation intervention after hepatic encephalopathy

What Is the ethical (Not Legal) responsibility of a physician to treat minimal hepatic encephalopathy and advise patients not to drive?

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