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An integrated alcohol abuse and medical treatment model for patients with hepatitis C.

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Date
2012-04
Authors
Proeschold-Bell, Rae Jean
Patkar, Ashwin A
Naggie, Susanna
Coward, Lesleyjill
Mannelli, Paolo
Yao, Jia
Bixby, Patricia
Muir, Andrew J
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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 article
Subject
Adult
Aged
Alcoholism
Counseling
Female
Hepatitis C, Chronic
Humans
Male
Middle Aged
Patient Care Team
Psychotherapy, Group
Temperance
Permalink
https://hdl.handle.net/10161/6209
Published Version (Please cite this version)
10.1007/s10620-011-1976-4
Publication 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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Scholars@Duke

Mannelli

Paolo Mannelli

Associate Professor of Psychiatry and Behavioral Sciences
Muir

Andrew Joseph Muir

Professor of Medicine
Hepatitis C  Primary sclerosing cholangitis Cirrhosis Liver Transplantation Clinical Trials Healthcare disparities in liver disease  Outcomes Research
Naggie

Susanna Naggie

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 a Professor of Medicine and currently holds joint appointments at the Duke Clinical Research Institute and at the Durham Veterans Affa
Patkar

Ashwin Anand Patkar

Professor of Psychiatry and Behavioral Sciences
Proeschold-Bell

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
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