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.

Department

Description

Provenance

Citation

Published Version (Please cite this version)

10.1007/s10620-011-1976-4

Publication Info

Proeschold-Bell, Rae Jean, Ashwin A Patkar, Susanna Naggie, Lesleyjill Coward, Paolo Mannelli, Jia Yao, Patricia Bixby, Andrew J Muir, et al. (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.

Scholars@Duke

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 caregivers of orphaned and vulnerable children in Kenya, Ethiopia, India, and Cambodia.

Soon, she will be testing four interventions to reduce stress symptoms.

As someone trained in both clinical and community psychology, Rae Jean is interested in the impact of systems and environmental contexts on individuals.

Naggie

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 Duke University School of Medicine, at the Duke Clinical Research Institute, and at the Durham Veterans Affairs Medical Center. Dr. Naggie is a clinical investigator with a focus in clinical trials in infectious diseases and translational research in HIV and liver disease. She is a standing member of the DHHS Panel on Antiretroviral Guidelines for Adults and Adolescents and the CDC/NIH/IDSA-HIVMA Opportunistic Infections Guideline. She is the Vice Dean for Clinical and Translational Research and Director for the Duke Clinical and Translational Sciences Institute.


Unless otherwise indicated, scholarly articles published by Duke faculty members are made available here with a CC-BY-NC (Creative Commons Attribution Non-Commercial) license, as enabled by the Duke Open Access Policy. If you wish to use the materials in ways not already permitted under CC-BY-NC, please consult the copyright owner. Other materials are made available here through the author’s grant of a non-exclusive license to make their work openly accessible.