Digestive Diseases and Sciences

, Volume 57, Issue 4, pp 1083–1091

An Integrated Alcohol Abuse and Medical Treatment Model for Patients with Hepatitis C

  • Rae Jean Proeschold-Bell
  • Ashwin A. Patkar
  • Susanna Naggie
  • Lesleyjill Coward
  • Paolo Mannelli
  • Jia Yao
  • Patricia Bixby
  • Andrew J. Muir
Original Article

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.

Keywords

HCV Alcohol-related disorders Delivery of health care Integrated care Hepatology clinic 

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Rae Jean Proeschold-Bell
    • 1
  • Ashwin A. Patkar
    • 2
  • Susanna Naggie
    • 3
    • 4
  • Lesleyjill Coward
    • 5
  • Paolo Mannelli
    • 2
    • 6
  • Jia Yao
    • 1
  • Patricia Bixby
    • 7
  • Andrew J. Muir
    • 3
    • 5
  1. 1.Duke Global Health Institute, Center for Health Policy and Inequalities ResearchDuke UniversityDurhamUSA
  2. 2.Duke Addictions Program and Substance Abuse Consultation ServicesDuke University Medical CenterDurhamUSA
  3. 3.Duke Clinical Research Institute, Duke School of MedicineDuke University Medical CenterDurhamUSA
  4. 4.Division of Infectious DiseaseDuke University/Durham VA Medical CenterDurhamUSA
  5. 5.Department of GastroenterologyDuke University Medical CenterDurhamUSA
  6. 6.Department of Psychiatry and Behavioral SciencesDuke University Medical CenterDurhamUSA
  7. 7.Department of MedicineDuke University School of MedicineDurhamUSA

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