Significant Reductions in Drinking Following Brief Alcohol Treatment Provided in a Hepatitis C Clinic

Dieperink, Eric; Ho, Samuel B.; Heit, Sara; Durfee, Janet; Thuras, Paul; Willenbring, Mark L.

doi:10.1176/appi.psy.51.2.149

Cited by 20 publications

(25 citation statements)

References 31 publications

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“…We included eight observational studies, with all but three 28, 29, 32 conducted outside the United States (Table 2). 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).…”

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). All eight non-randomized studies were judged to be at medium risk of bias based on Downs and Black bias scale ratings 20 (Table 4).…”

Section: Resultsmentioning

confidence: 99%

“…Five studies (1 non-randomized study with historical control group 26 and 4 pre-post studies 28, 29, 32, 33 ) reported data on achieving alcohol abstinence. Andersen et al in their non-randomized historically controlled study reported a higher likelihood of achieving alcohol abstinence in patients with ALD and advanced liver disease receiving supportive therapy by a nurse, weekly for one year versus usual therapy at one-year follow up (26% versus 7.1% respectively).…”

Section: Resultsmentioning

confidence: 99%

“…We found one RCT and 3 observational studies that used integrated therapy with the same provider delivering mental health and liver disease care 21 or an integrated multidisciplinary team approach by both liver disease and mental health providers in the same location with close communication 27, 29 . Integrated therapy resulted in a significantly higher rate of alcohol abstinence compared to control group in one RCT 21.…”

Section: Resultsmentioning

confidence: 99%

“…Specifically, we found four studies (1 RCT and 3 observational studies) that evaluated an integrated approach and reported a similar magnitude of effects (36%– 75%). These studies examined a range of psychotherapies (combination therapies which included combinations of CBT and MET 21 , CBT, MET and psychoeducation 28 and CBT, MET and MI 29 ) and enrolled patients with varying degree of liver disease severity. Besides the integrated care delivery, it is difficult to isolate intervention characteristics that resulted in better alcohol use outcomes given the wide range of therapeutic approaches employed.…”

Section: Discussionmentioning

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

134

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%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

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

134

113

View full text Add to dashboard Cite

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Association Between Alcohol Use Disorder and Receipt of Direct-Acting Antiviral Hepatitis C Virus Treatment

et al. 2022

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ImportanceDirect-acting antiviral (DAA) treatment for hepatitis C virus (HCV) infection is associated with lower mortality and is effective in individuals with alcohol use disorder (AUD). However, despite recommendations, patients with AUD may be less likely to receive DAAs.ObjectiveTo assess the association between alcohol use and receipt of DAA treatment among patients with HCV within the Veterans Health Administration (VHA).Design, Setting, and ParticipantsThis cohort study included 133 753 patients with HCV born from 1945 to 1965 who had completed the Alcohol Use Disorders Identification Test–Consumption (AUDIT-C) questionnaire and had at least 1 outpatient visit in the VHA from January 1, 2014, through May 31, 2017, with maximal follow-up of 3 years until May 31, 2020; DAA receipt; or death, whichever occurred first.ExposuresAlcohol use categories generated using responses to the AUDIT-C questionnaire and International Classification of Diseases, Ninth Revision and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnoses: current AUD, abstinent with AUD history, at-risk drinking, lower-risk drinking, and abstinent without AUD history. Demographic, other clinical, and pharmacy data were also collected.Main Outcomes and MeasuresAssociations between alcohol use categories and DAA receipt within 1 and 3 years estimated using Cox proportional hazards regression stratified by calendar year.ResultsOf 133 753 patients (130 103 men [97%]; mean [SD] age, 60.6 [4.5] years; and 73 493 White patients [55%]), 38% had current AUD, 12% were abstinent with a history of AUD, 6% reported at-risk drinking, 14% reported lower-risk drinking, and 30% were abstinent without a history of AUD. Receipt of DAA treatment within 1 year was 7%, 33%, 53%, and 56% for patients entering the cohort in 2014, 2015, 2016, and 2017, respectively. For patients entering in 2014, those with current AUD (hazard ratio [HR], 0.72 [95%, CI, 0.66-0.77]) or who were abstinent with an AUD history (HR, 0.91 [95% CI, 0.84-1.00]) were less likely to receive DAA treatment within 1 year compared with patients with lower-risk drinking. For those entering in 2015-2017, patients with current AUD (HR, 0.75 [95% CI, 0.70-0.81]) and those who were abstinent with an AUD history (HR, 0.76 [95% CI, 0.68-0.86]) were less likely to receive DAA treatment within 1 year compared with patients with lower-risk drinking.Conclusions and RelevanceThis cohort study suggests that individuals with AUD, regardless of abstinence, were less likely to receive DAA treatment. Improved access to DAA treatment for persons with AUD is needed.

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Diagnosis and Treatment of Alcohol‐Associated Liver Diseases: 2019 Practice Guidance From the American Association for the Study of Liver Diseases

et al. 2020

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Significant Reductions in Drinking Following Brief Alcohol Treatment Provided in a Hepatitis C Clinic

Cited by 20 publications

References 31 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

Association Between Alcohol Use Disorder and Receipt of Direct-Acting Antiviral Hepatitis C Virus Treatment

Diagnosis and Treatment of Alcohol‐Associated Liver Diseases: 2019 Practice Guidance From the American Association for the Study of Liver Diseases

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