Alcohol misuse in patients with alcohol-related liver disease: How can we do better? A narrative review of the literature.
alcohol use disorder
alcohol-related liver disease
barriers
engagement
psychosocial factors
Journal
Alcoholism, clinical and experimental research
ISSN: 1530-0277
Titre abrégé: Alcohol Clin Exp Res
Pays: England
ID NLM: 7707242
Informations de publication
Date de publication:
08 2022
08 2022
Historique:
revised:
16
06
2022
received:
28
03
2022
accepted:
17
06
2022
pubmed:
30
6
2022
medline:
1
9
2022
entrez:
29
6
2022
Statut:
ppublish
Résumé
Ongoing alcohol use is strongly associated with progressive liver damage and higher mortality in patients with alcohol-related liver disease (ArLD). Reduction in alcohol use is therefore the cornerstone of treatment to improve the long-term outcome of these patients. However, a large proportion of patients continue to use alcohol and do not access or engage with alcohol treatment services after a diagnosis of ArLD. We reviewed the literature on factors associated with ongoing alcohol consumption among patients with ArLD to identify barriers or facilitators to their accessing alcohol treatment. A search of MEDLINE and EMBASE was conducted using search strategies relating to ArLD and the psychosocial factors hypothesized to influence alcohol reduction and/or abstinence. There were few relevant studies pertinent to this population group. Several studies reported a high prevalence of mental health diagnoses associated with the severity of alcohol dependence. Social and environmental factors were shown to be important determinants of alcohol use. Common themes perceived as barriers to treatment from qualitative interviews with ArLD patients across studies included poor communication between the clinical team and patient, lack of symptoms recognized by patients themselves, and perceived loss of control over their condition. We recommend that future clinical studies of patient cohorts with ArLD include detailed psychosocial assessments to capture information on mental health and social factors. Qualitative studies are required to explore the patient journey pre and post hospital admission, which should focus on identifying facilitators and barriers to accessing treatment. Well-designed, controlled studies are needed to identify patient, social, and environmental factors associated with relapse to alcohol use after a diagnosis of ArLD. These data will enable us to adapt our support for patients to enhance engagement with services and improve long-term outcomes.
Sections du résumé
BACKGROUND
Ongoing alcohol use is strongly associated with progressive liver damage and higher mortality in patients with alcohol-related liver disease (ArLD). Reduction in alcohol use is therefore the cornerstone of treatment to improve the long-term outcome of these patients. However, a large proportion of patients continue to use alcohol and do not access or engage with alcohol treatment services after a diagnosis of ArLD. We reviewed the literature on factors associated with ongoing alcohol consumption among patients with ArLD to identify barriers or facilitators to their accessing alcohol treatment.
METHODS
A search of MEDLINE and EMBASE was conducted using search strategies relating to ArLD and the psychosocial factors hypothesized to influence alcohol reduction and/or abstinence.
RESULTS
There were few relevant studies pertinent to this population group. Several studies reported a high prevalence of mental health diagnoses associated with the severity of alcohol dependence. Social and environmental factors were shown to be important determinants of alcohol use. Common themes perceived as barriers to treatment from qualitative interviews with ArLD patients across studies included poor communication between the clinical team and patient, lack of symptoms recognized by patients themselves, and perceived loss of control over their condition.
CONCLUSIONS
We recommend that future clinical studies of patient cohorts with ArLD include detailed psychosocial assessments to capture information on mental health and social factors. Qualitative studies are required to explore the patient journey pre and post hospital admission, which should focus on identifying facilitators and barriers to accessing treatment. Well-designed, controlled studies are needed to identify patient, social, and environmental factors associated with relapse to alcohol use after a diagnosis of ArLD. These data will enable us to adapt our support for patients to enhance engagement with services and improve long-term outcomes.
Identifiants
pubmed: 35766348
doi: 10.1111/acer.14895
pmc: PMC9543176
doi:
Substances chimiques
Ethanol
3K9958V90M
Types de publication
Journal Article
Review
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1364-1370Subventions
Organisme : Department of Health
Pays : United Kingdom
Informations de copyright
© 2022 The Authors. Alcoholism: Clinical & Experimental Research published by Wiley Periodicals LLC on behalf of Research Society on Alcoholism.
Références
J Clin Nurs. 2016 Sep;25(17-18):2457-67
pubmed: 27256537
J Subst Abuse Treat. 2018 Aug;91:20-27
pubmed: 29910011
Cochrane Database Syst Rev. 2017 Mar 31;3:CD011646
pubmed: 28368093
Br J Nurs. 2018 Jul 12;27(13):730-736
pubmed: 29995513
Alcohol Res. 2019 Jan 01;40(1):
pubmed: 31649834
J Hepatol. 2019 Mar;70(3):521-530
pubmed: 30658117
Hepatology. 2017 Dec;66(6):1842-1853
pubmed: 28646515
J Hepatol. 2016 Sep;65(3):618-30
pubmed: 27155530
Arch Gen Psychiatry. 1998 Mar;55(3):259-65
pubmed: 9510220
Hepatol Res. 2012 Apr;42(4):359-67
pubmed: 22150916
Psychosomatics. 1998 Nov-Dec;39(6):501-11
pubmed: 9819950
Hepatology. 2017 Nov;66(5):1464-1473
pubmed: 28459138
N Engl J Med. 2015 Apr 23;372(17):1619-28
pubmed: 25901427
Scand J Gastroenterol. 2017 Nov;52(11):1278-1285
pubmed: 28830264
J Stud Alcohol. 1993 Nov;54(6):645-51
pubmed: 8271799
Clin Gastroenterol Hepatol. 2016 Feb;14(2):191-202.e1-4; quiz e20
pubmed: 26256464
Psychosom Med. 2015 Nov-Dec;77(9):1018-30
pubmed: 26517474
JAMA Psychiatry. 2013 Jul;70(7):718-26
pubmed: 23636710
Gastroenterology. 1981 Jun;80(6):1405-9
pubmed: 6971772
Br J Addict. 1986 Apr;81(2):231-5
pubmed: 3458491
BMC Public Health. 2017 May 8;17(1):412
pubmed: 28482876
J Hepatol. 2018 Jul;69(1):154-181
pubmed: 29628280
Lancet. 2014 Nov 29;384(9958):1953-97
pubmed: 25433429
Alcohol Alcohol. 1984;19(4):297-302
pubmed: 6532466
J Stud Alcohol. 1988 Jul;49(4):375-7
pubmed: 3172787
Kobe J Med Sci. 2019 Nov 12;65(3):E80-E89
pubmed: 32029692
Alcohol Alcohol. 1994 Jul;29(4):459-63
pubmed: 7986284
Arch Gen Psychiatry. 2005 Jun;62(6):593-602
pubmed: 15939837
Lancet. 1995 Oct 14;346(8981):987-90
pubmed: 7475591
J Hepatol. 1986;2(1):33-42
pubmed: 3950362
J Psychosom Res. 2019 Jan;116:75-82
pubmed: 30654998
Alcohol Clin Exp Res. 2018 Oct;42(10):1933-1938
pubmed: 30080255
Alcohol Clin Exp Res. 2022 Aug;46(8):1364-1370
pubmed: 35766348
Health Technol Assess. 2015 Dec;19(102):1-104
pubmed: 26691209
Alcohol Res. 2016;38(1):83-94
pubmed: 27159815
J Hepatol. 2019 Feb;70(2):294-304
pubmed: 30658730
Alcohol Alcohol. 2009 Jul-Aug;44(4):409-15
pubmed: 19491281
Clin Liver Dis. 2019 Feb;23(1):55-69
pubmed: 30454833
J Adv Nurs. 2016 Jan;72(1):173-85
pubmed: 26446497