An integrated alcohol abuse and medical treatment model for patients with hepatitis C.
Abstract
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.
Type
Journal articleSubject
AdultAged
Alcoholism
Counseling
Female
Hepatitis C, Chronic
Humans
Male
Middle Aged
Patient Care Team
Psychotherapy, Group
Temperance
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https://hdl.handle.net/10161/6209Published Version (Please cite this version)
10.1007/s10620-011-1976-4Publication Info
Proeschold-Bell, Rae Jean; Patkar, Ashwin A; Naggie, Susanna; Coward, Lesleyjill;
Mannelli, Paolo; Yao, Jia; ... Muir, Andrew J (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 https://hdl.handle.net/10161/6209.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Paolo Mannelli
Professor of Psychiatry and Behavioral Sciences
Andrew Joseph Muir
Professor of Medicine
Hepatitis C
Primary sclerosing cholangitis
Cirrhosis
Liver Transplantation
Clinical Trials
Healthcare disparities in liver disease
Outcomes Research
Susanna Naggie
Professor of Medicine
Dr. Susanna Naggie completed her undergraduate degrees in chemical engineering and
biochemistry at the University of Maryland, College Park, and her medical education
at Johns Hopkins School of Medicine. She conducted her internal medicine and infectious
diseases fellowship training at Duke University Medical Center, where she also served
as Chief Resident. She joined the faculty in the Duke School of Medicine in 2009.
She is a Professor of Medicine and currently holds appointments at the Duk
Ashwin Anand Patkar
Professor of Psychiatry and Behavioral Sciences
Rae Jean Proeschold-Bell
Research Professor of Global Health
Rae Jean Proeschold-Bell is interested in the interplay between mental and physical
well-being and has designed and tested interventions that integrate care for people
with obesity and depression; HIV/AIDS and substance use; and hepatitis C and alcohol
use. Most recently, Rae Jean has been studying positive mental health as a way to
prevent depression and promote caring for one's physical health. Her work currently
focuses on caregivers, including clergy in North Carolina and ca
Alphabetical list of authors with Scholars@Duke profiles.

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