An integrated alcohol abuse and medical treatment model for patients with hepatitis C.
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BACKGROUND: Patients with chronic hepatitis C virus (HCV) infection have high rates of alcohol consumption, which is associated with progression of fibrosis and lower response rates to HCV treatment. AIMS: This prospective cohort study examined the feasibility of a 24-week integrated alcohol and medical treatment to HCV-infected patients. METHODS: Patients were recruited from a hepatology clinic if they had an Alcohol Use Disorders Identification Test score >4 for women and >8 for men, suggesting hazardous alcohol consumption. The integrated model included patients receiving medical care and alcohol treatment within the same clinic. Alcohol treatment consisted of 6 months of group and individual therapy from an addictions specialist and consultation from a study team psychiatrist as needed. RESULTS: Sixty patients were initially enrolled, and 53 patients participated in treatment. The primary endpoint was the Addiction Severity Index (ASI) alcohol composite scores, which significantly decreased by 0.105 (41.7% reduction) between 0 and 3 months (P < 0.01) and by 0.128 (50.6% reduction) between 0 and 6 months (P < 0.01) after adjusting for covariates. Alcohol abstinence was reported by 40% of patients at 3 months and 44% at 6 months. Patients who did not become alcohol abstinent had reductions in their ASI alcohol composite scores from 0.298 at baseline to 0.219 (26.8% reduction) at 6 months (P = 0.08). CONCLUSION: This study demonstrated that an integrated model of alcohol treatment and medical care could be successfully implemented in a hepatology clinic with significant favorable impact on alcohol use and abstinence among patients with chronic HCV.
Hepatitis C, Chronic
Patient Care Team
Published Version (Please cite this version)10.1007/s10620-011-1976-4
Publication InfoBixby, P; Coward, L; Mannelli, Paolo; Muir, Andrew; Naggie, Susanna; Patkar, AA; ... Yao, Jia (2012). An integrated alcohol abuse and medical treatment model for patients with hepatitis C. Dig Dis Sci, 57(4). pp. 1083-1091. 10.1007/s10620-011-1976-4. Retrieved from http://hdl.handle.net/10161/6209.
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Associate Professor of Psychiatry and Behavioral Sciences
Professor of Medicine
Hepatitis C Primary sclerosing cholangitis Cirrhosis Liver Transplantation Clinical Trials Healthcare disparities in liver disease Outcomes Research
Associate Professor of Medicine
Dr. Susanna Naggie completed her medical education at Johns Hopkins School of Medicine and her internal medicine training at Duke University Medical Center (DUMC), where she also served as a Chief Resident in Internal Medicine. She completed her Infectious Diseases (ID) fellowship training at Duke and then joined the faculty in the Division of ID. She is an Associate Professor of Medicine with Tenure and currently holds joint appointments at the Duke Clinical Research Institute (DCRI, D
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