Communicating about Alcohol Consumption to Nonharmful Drinkers with Hepatitis C: Patient and Provider Perspectives

Abstract

BACKGROUND:Abstaining from alcohol consumption is generally recommended for patients with Hepatitis C (HCV). However, mixed research findings coupled with a lack of consistent guidelines on alcohol consumption and HCV may influence what healthcare providers tell their HCV patients about drinking. This may be more problematic when advising nonharmful drinkers with HCV, a population for whom consumption would not be a problem in the absence of their HCV diagnosis. OBJECTIVE:This study explores what healthcare providers advise their HCV patients who are drinking alcohol at nonharmful levels about alcohol use and what these patients actually hear. DESIGN:We conducted separate focus groups and interviews about alcohol use and HCV with nonharmful drinkers with HCV (N=50) and healthcare providers (N= 14) at a metropolitan teaching hospital. All focus groups and interviews were audio-taped, transcribed, and analyzed using NVivo, a qualitative data management and analysis program. RESULTS:We found similar themes about HCV and alcohol consumption (stop completely, occasional drink is ok, cut down, and provision of mixed/ambiguous messages), reported by both providers and patients. Patient respondents who reported hearing "stop completely" were more likely to have had their last medical visit at the gastroenterology (GI) clinic as opposed to the internal medicine (IM) clinic. Furthermore, IM providers were more likely to give their recommendations in "medical language" than were GI providers. CONCLUSIONS:To make the best health-related decisions about their disease, HCV patients need consistent information about alcohol consumption. Departments of Internal Medicine can increase provider knowledge about HCV and alcohol use by providing more education and training on HCV.

Segmenting Excessive Alcohol Consumers: Implications for Social Marketing

“…This construct therefore reflects an individual’s overall attitude towards the health care system as well as the willingness to interact with health service providers. As prior literature suggests that patients’ adherence is partially determined by aspects of the patient-doctor relationship (Blixen et al, 2008; Vermeire et al, 2001), health management style may be crucial to consider for reducing alcohol consumption.…”

“…In particular, no previous study could be found that has utilized psychographic segmentation based on health management styles to segment heavy drinkers for understanding their attitudes and behaviours. This is important as past research demonstrates that aspects of the patient-doctor relationship (Blixen et al, 2008; Vermeire et al, 2001; Sutton et al, 2015) play a key role in reducing alcohol consumption. For example, a recent study demonstrates that aspects of health management styles such as cooperation with doctors, trust in doctors and living a healthy lifestyle are significantly related to alcohol consumption (Perzynski et al, 2011).…”

Chronic hepatitis C and antiviral treatment regimens: Where can psychology contribute?

“…Hence, recommendations for alcohol abuse counseling for heavy alcohol consumers are empirically-driven, but those for lighter drinkers are not, until more data are obtained. The lack of data and the consequent vagueness of practice guidelines leads to idiosyncratic physician decisions and mixed messages for patients (Blixen et al, 2008). Interventions to reduce excess alcohol consumption are needed.…”

Risky Alcohol Use and Serum Aminotransferase Levels in HIV-Infected Adults With and Without Hepatitis C

“…Despite these measures and guidelines that recommend counseling patients to abstain or moderate alcohol use in the context of HCV, patients may still receive confl icting messages, perhaps in part because of physicians' awareness of evidence gaps (Blixen et al, 2008). Yet even when patients with HCV are counseled appropriately, numerous psychosocial factors may interfere with their ability to comply with recommendations to limit drinking (Perzynski et al, 2011). This study reinforces the need to target HCV-infected patients as a riskier subgroup for alcohol-related risks among HIV-infected populations, and supports research to develop tailored interventions to reduce drinking.…”