Alcohol misuse in patients with alcohol‐related liver disease: How can we do better? A narrative review of the literature

Horrell, Jane; Callaghan, Lynne; Dhanda, Ashwin

doi:10.1111/acer.14895

Cited by 8 publications

(3 citation statements)

References 38 publications

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“…21 Other reasons for decreased adherence include the denial of the disease, 22 poor insight into AUD and the need for treatment (little acceptance that AUD can be treated, or absence of physical symptoms), misconceptions about the treatment of alcoholism or lack of social support systems. 7 , 22 – 25 Therefore, patients with an ArLD represent a susceptible population to receive specific interventions to improve treatment adherence to achieve abstinence. However, there are few studies in these patients on pharmacological or psychological interventions to improve adherence and prognosis of AUD.…”

Section: Introductionmentioning

confidence: 99%

Multiplatform web app (My Way Up) plus motivational interviewing for improving treatment retention in patients with onset of alcohol-related liver disease and alcohol use disorder – an example of participatory research

Caballeria,

Balcells-Oliveró,

Bataller

et al. 2024

DIGITAL HEALTH

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Background With the aim of improving treatment retention in patients with the onset of alcohol-related liver disease (ArLD), we designed a blended intervention (brief motivational intervention + ‘serious game’ (SG)). We present the participatory design methodology and outcomes and the usability assessment of the intervention. Methods (1) The design of the SG was based on the outcomes of two 3-h co-creation sessions with 37 participants (healthcare and technology professionals, patients, and patients’ relatives). The brief face-to-face motivational intervention was based on the 5 As Model and adapted to the ArLD population. (2) Usability pilot study: 20 participants (10 ArLD patients + 10 healthcare professionals) received the intervention. System Usability Scale (SUS) and Post-Study System Usability Questionnaire (PSSUQ) were applied to assess the SG usability and patients’ satisfaction with it. Weekly semi-structured interviews on the phone were conducted to identify the preferred elements in the SG and those aspects that should be improved. Results (1) Design: an SG in the form of a gamified web app, consisting of a daily activity for six weeks and adapted brief motivational interviewing. (2) Usability pilot study: usability results were excellent for both patients and healthcare professionals (SUS median score = 85). The general usability, the quality of the information provided by the SG and the quality of the interface were very positively rated in the PSSUQ (overall median score = 2, IQR = 1–2). The best-rated aspects were the provision of feedback, the use of metaphors and the application of audiovisual material. Changes in the design, response mechanics and content were applied after the study. Conclusions The usability and acceptability of an intervention for increasing retention to treatment in patients with recent onset of ArLD and AUD were excellent for patients and healthcare professionals. A randomized-controlled trial is required to test the efficacy of this approach.

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Section: Introductionmentioning

confidence: 99%

Multiplatform web app (My Way Up) plus motivational interviewing for improving treatment retention in patients with onset of alcohol-related liver disease and alcohol use disorder – an example of participatory research

Caballeria,

Balcells-Oliveró,

Bataller

et al. 2024

DIGITAL HEALTH

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“…It has a high incidence rate, great harm, easy recurrence, and other characteristics, causing a serious economic and psychological burden on families and society ( 11 ). Research has shown that patients with alcohol dependence syndrome generally have depressive emotions and are not easily identifiable, increasing the risk of suicide for patients ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

Effect of family intervention on relapse rate of Chinese patients with alcohol-dependent

Wang,

Tang,

Chen

et al. 2024

Front. Public Health

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ObjectiveThis study explored the impact of a family intervention on the relapse rate of Chinese patients with alcohol dependence.MethodsA total of 151 male patients with alcohol dependence who were discharged from the Substance Dependence Department of the Wenzhou Seventh People’s Hospital from January to December 2020 were selected. They were divided into the control (n = 73) and experimental (n = 78) groups. Patients in both groups received routine alcohol cessation treatment. Moreover, patients in the experimental group were followed up by a professional psychiatrist to carry out individual family intervention. The Family Function Rating Scale (FAD), a Self-made general information questionnaire, and the Chinese version of the Family Intimacy and Adaptability Scale (FACESI-CV) were performed. Re-drinking rate and readmission rate were assessed.ResultsFamily intervention could reduce relapse rate (31, 39.74%) and rehospitalization (27, 34.62%) compared with the control group. After family training, FAD factor scores were improved in the experiment group in comparison with the control group. Family training improved communication (18.2 ± 3.7), role (20.8 ± 2.5), emotional response (10.8 ± 1.8), emotional involvement (13.7 ± 1.2), behavioral control (19.8 ± 1.2), and overall functionality (23.5 ± 2.1) in the experiment group in comparison with the control group. After family training, intimacy (70.5 ± 8.7) and adaptability (64.1 ± 6.9) in the experiment group was higher than in the control group. After family intervention, Michigan Alcohol Dependence Scale (MAST) (9.21 ± 0.68) and Short-Form 36 (SF-36) (80.32 ± 4.47) in the experiment group were higher than the control group.ConclusionFamily intervention for families of patients with alcohol dependence can improve their family function, increase their family intimacy and adaptability, and reduce the rate of relapse.

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“…Alcohol abuse or alcoholism is due to many reasons, such as occupational risk factors, social isolation, and employment status, which results in neurotic disorder and antisocial personality. Alcohol dependence, poor understanding, lack of symptoms, and lack of control from abstinence make aggressive alcohol use disorder in individuals (Horrell et al, 2022; Kerr et al, 2022). Chronic or binge excessive alcohol consumption (80 g of alcohol a day) is known to cause metabolism‐associated liver diseases like reversible fatty changes in 80% of heavy drinkers (Levene & Goldin, 2012).…”

Section: Introductionmentioning

confidence: 99%

Insights of mitochondrial involvement in alcoholic fatty liver disease

Subramaiyam

2023

Journal Cellular Physiology

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Alcoholic liver disease (ALD) is a global concern affecting most of the population and leading to the development of end‐stage liver disease. Metabolic alterations due to increased alcohol consumption surge the hepatic accumulation of lipids and develop into a severe form of alcoholic steatohepatitis (ASH), depending on age and the consumption rate. The mitochondria in the hepatocyte actively regulate metabolic homeostasis and are disrupted in ALD pathogenesis. The increased NADH upon ethanol metabolism inhibits the mitochondrial oxidation of fatty acids, alters oxidative phosphorylation, and favors de novo lipogenesis. The higher mitochondrial respiration in early ALD increases free radical generation, whereas mitochondrial respiration is uncoupled in chronic ALD, affecting the cellular energy status. The defective glutathione importer due to excessive cholesterol loading and low adenosine triphosphate accounts for additional oxidative stress leading to hepatocyte apoptosis. The defective mitochondrial transcription machinery and sirtuins function in ALD affect mitochondrial function and biogenesis. The metabolites of ethanol metabolism epigenetically alter the gene expression profile of hepatic cell populations by modulating the promoters and sirtuins, aiding hepatic fibrosis and inflammation. The defect in mitophagy increases the accumulation of megamitochondria in hepatocytes and attracts immune cells by releasing mitochondrial damage‐associated molecular patterns to initiate hepatic inflammation and ASH progression. Thus, maintaining mitochondrial lipid homeostasis and antioxidant capacity pharmacologically could provide a better outcome for ALD management.

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Alcohol misuse in patients with alcohol‐related liver disease: How can we do better? A narrative review of the literature

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Cited by 8 publications

References 38 publications

Multiplatform web app (My Way Up) plus motivational interviewing for improving treatment retention in patients with onset of alcohol-related liver disease and alcohol use disorder – an example of participatory research

Multiplatform web app (My Way Up) plus motivational interviewing for improving treatment retention in patients with onset of alcohol-related liver disease and alcohol use disorder – an example of participatory research

Effect of family intervention on relapse rate of Chinese patients with alcohol-dependent

Insights of mitochondrial involvement in alcoholic fatty liver disease

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