Does Advice Based on Biomarkers of Liver Injury or Non-Invasive Tests of Liver Fibrosis Impact High-Risk Drinking Behaviour: A Systematic Review With Meta-analysis

Subhani, Mohsan; Knight, Holly; Ryder, Stephen D.; Morling, Joanne R

doi:10.1093/alcalc/agaa143

Cited by 23 publications

(23 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Supplementing liver function tests with NITs to stratify the severity of liver disease in high-risk areas such as community alcohol services can significantly enhance the early-detection rate [ 22 , 30 , 31 ]. Similar changes in alcohol consumption in response to NITs of liver disease have been previously reported in patients with hazardous alcohol consumption in primary and secondary care but not in community alcohol services [ 22 , 23 , 32 ]. This change in alcohol consumption is backed up by previous evidence showing that providing personalised health care communications enhances the motivation to overcome addictive behaviour [ 33 , 34 ].…”

Section: Discussionsupporting

confidence: 71%

“…This is known to be the most effective way of preventing liver disease progression [ 21 ]. Providing feedback to patients based on NITs of liver disease can impact drinking behaviour [ 22 , 23 ]. It has been hypothesised that the demonstration of the degree of liver damage related to excess drinking, combined with advice to reduce alcohol consumption, would be more effective [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

“…Providing feedback to patients based on NITs of liver disease can impact drinking behaviour [ 22 , 23 ]. It has been hypothesised that the demonstration of the degree of liver damage related to excess drinking, combined with advice to reduce alcohol consumption, would be more effective [ 23 ]. In contrast, concerns have also been raised regarding the risks of NIT-based feedback methods potentially providing false reassurance, leading to unintended negative consequences such as exacerbating pre-existing addictive behaviours [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Transient Elastography in Community Alcohol Services: Can It Detect Significant Liver Disease and Impact Drinking Behaviour?

et al. 2022

Self Cite

View full text Add to dashboard Cite

Introduction: Alcohol is the leading cause of cirrhosis in Western populations. The early identification of high-risk drinkers followed by intervention is an effective way to reduce harm. We aim to assess the feasibility of integrating transient elastography (TE) into community alcohol services, and to determine its impact on modifying drinking behaviours. Method: A prospective cohort study was conducted at a community alcohol clinic in Nottingham, UK (April 2012 to March 2014). Patients (>18 years) with a primary alcohol problem were recruited. Those known to liver services or those known to have chronic liver disease were excluded. Significant liver fibrosis was defined by a liver stiffness of >8 kilopascal (kPa). Follow-up was for a minimum of six months. Data were descriptively analysed for significant differences between patients with a normal liver stiffness versus raised liver stiffness. Results: 156 patients were invited; n = 87 attended and n = 86 underwent successful TE. The majority were male (n = 53, 70.0%), and the mean age was 46.3 years (SD ± 9.8). Median liver stiffness was 6.9 kPa (range 3.1–75.0kPa). Clinically significant liver fibrosis was identified in n = 33 (38.4%), of which n = 6 were in the cirrhotic range (≥15 kPa). The baseline median self-reported alcohol intake for normal stiffness was 126 units per week (range 24–378) and in raised stiffness was 149.0 units per week (range 39.0–420.0); this difference was nonsignificant (p = 0.338). The median reduction in self-reported alcohol intake in the whole cohort was 65.0 units per week (range 27.0–88.0, p < 0.001); in the normal liver stiffness group it was 25.0 units per week (range 18.0–75.0, p = 0.154), and in the raised liver stiffness group it was 78.5 units per week (range 36.0–126.0, p < 0.001). Conclusion: The study demonstrated that transient elastography is a feasible tool to stratify clinically significant liver disease in community alcohol services. It can stimulate a change in high-risk drinking behaviour and a normal liver stiffness result does not provide false reassurance to participants.

show abstract

Section: Discussionsupporting

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Transient Elastography in Community Alcohol Services: Can It Detect Significant Liver Disease and Impact Drinking Behaviour?

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…Secondary to the social stigma associated with smoking, patients are reluctant to engage with their physicians about the hazards of smoking [26]. However, CHD prevention has no such social stigma, and recent work with biomarkers of hepatic injury has shown the benefit of physicians conveying similar information about the protective effects of alcohol cessation on liver function to patients with alcohol dependence [27]. Using potential effects of smoking cessation on CHD risk, alone or together with incentive-based programming methods for smoking cessation, could be a powerful motivator to persuade nicotine-dependent smokers to quit [16].…”

Section: Discussionmentioning

confidence: 99%

The Reversion of DNA Methylation at Coronary Heart Disease Risk Loci in Response to Prevention Therapy

et al. 2021

View full text Add to dashboard Cite

Coronary heart disease (CHD) is preventable, but the methods for assessing risk and monitoring response rely on imprecise lipid-based assessments. Recently, we have shown that an integrated genetic–epigenetic test that includes three methylation-sensitive digital PCR assays predicts 3-year risk for incident CHD better than lipid-based methods. However, whether methylation sites change in response to therapies that alter CHD risk is not known. Therefore, we assessed methylation at these three incident CHD-related sites in DNA from 39 subjects before and after three months of biochemically verified smoking cessation, then analyzed the relationship between change in methylation at each of the sites to the change in smoking intensity as assessed by cg05575921 methylation. We found that, in those who quit smoking, methylation change at one CHD risk marker (cg00300879) was significantly associated with change in cg05575921 methylation (p < 0.04). We conclude that changes in incident CHD-related methylation occur within three months of cessation of smoking, a major risk factor for CHD. This suggests that the effectiveness of treatment of other CHD risk factors, such as high cholesterol, may be similarly quantifiable using epigenetic approaches. Further studies to determine the relationship of changes of methylation status in response to treatment of other CHD risk factors are indicated.

show abstract

“… 15 16 Moreover, a recent systematic review suggested providing feedback to patients based on markers of liver injury can be an effective way to reduce harmful alcohol intake. 17 Access to recovery stories can help address mental health problems and support recovery from addiction. 18 19 Peer support from people who have recovered from alcohol misuse is beneficial in modifying high risk drinking behaviour.…”

Section: Introductionmentioning

confidence: 99%

Does knowledge of liver fibrosis affect high-risk drinking behaviour (KLIFAD)? protocol for a feasibility randomised controlled trial

et al. 2021

Self Cite

View full text Add to dashboard Cite

IntroductionHeavy drinkers in contact with alcohol services do not routinely have access to testing to establish the severity of potential liver disease. Transient elastography by FibroScan can provide this information. A recent systematic review suggested providing feedback to patients based on markers of liver injury can be an effective way to reduce harmful alcohol intake. This randomised control trial (RCT) aims to establish the feasibility of conducting a larger national trial to test the effectiveness of FibroScan advice and Alcohol Recovery Video Stories (ARVS) in changing high-risk drinking behaviour in community alcohol services common to UK practice.Methods and analysisThis feasibility trial consists of three work packages (WP). WP1: To draft a standardised script for FibroScan operators to deliver liver disease-specific advice to eligible participants having FibroScan. WP2: To create a video library of ARVS for use in the feasibility RCT (WP3). WP3: To test the feasibility of the trial design, including the FibroScan script and video stories developed in WP1 and WP2 in a one-to-one individual randomised trial in community alcohol services. Semi-structured interviews will be conducted at 6 months follow-up for qualitative evaluation. Outcomes will be measures of the feasibility of conducting a larger RCT. These outcomes will relate to: participant recruitment and follow-up, intervention delivery, including the use of the Knowledge of LIver Fibrosis Affects Drinking trial FibroScan scripts and videos, clinical outcomes, and the acceptability and experience of the intervention and trial-related procedures. Data analysis will primarily be descriptive to address the feasibility aims of the trial. All proposed analyses will be documented in a Statistical Analysis Plan.Ethics and disseminationThis trial received favourable ethical approval from the West of Scotland Research Ethics Service (WoSRES) on 20 January 2021, REC reference: 20/WS/0179. Results will be submitted for publication to a peer-reviewed journal.Trial registration numberISRCTN16922410.

show abstract

Does Advice Based on Biomarkers of Liver Injury or Non-Invasive Tests of Liver Fibrosis Impact High-Risk Drinking Behaviour: A Systematic Review With Meta-analysis

Cited by 23 publications

References 40 publications

Transient Elastography in Community Alcohol Services: Can It Detect Significant Liver Disease and Impact Drinking Behaviour?

Transient Elastography in Community Alcohol Services: Can It Detect Significant Liver Disease and Impact Drinking Behaviour?

The Reversion of DNA Methylation at Coronary Heart Disease Risk Loci in Response to Prevention Therapy

Does knowledge of liver fibrosis affect high-risk drinking behaviour (KLIFAD)? protocol for a feasibility randomised controlled trial

Contact Info

Product

Resources

About