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
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