S1876 Integrating Care for Alcohol-Associated Liver Disease With Alcohol Use Disorder: Unique Single Center Experience
Notice bibliographique
Résumé
Introduction: Alcohol Use Disorder (AUD) has significant health, economic, and social consequences often leading to alcohol liver disease (ALD). Despite the necessity of alcohol cessation, < 5% of patients receive appropriate AUD care. In Canada, the underutilization of AUD treatment is compounded by geographic and socioeconomic disparities that further hinder access to care. This study examines the impact of integrated care on initiating AUD treatment, enhancing patient engagement, and reducing alcohol consumption in ALD patients. Methods: The study included patients who received integrated care at the Interdisciplinary ALD clinic at Health Sciences Centre, Winnipeg, Canada from March 2022 to June 2024. The interdisciplinary team comprised a hepatologist, addiction medicine specialist, psychiatrist and a patient partner. Participants included those with alcohol-associated cirrhosis or alcoholic hepatitis willing to engage in AUD treatment. Individualized care plans were developed, tailored to patient needs. The plans combined ALD management with AUD treatment and relapse prevention strategies, including behavioural therapy, psychotherapy, and pharmacotherapy. Patients completed AUDIT and EQ-VAS at baseline, 3 and 6 months. Baseline demographic, medical, liver disease and AUD treatment data were collected. Results: Overall, 52 patients were enrolled, median age 52 years (23-79), 60% males and 46% rural dwellers. Among participants, 37% were employed and 35% were on disability. Eighty percent had decompensated cirrhosis, 2 had hepatocellular carcinoma and 2 had liver transplantation. A significant majority (70%) had severe AUD. Of the participants, 72% received pharmacotherapy for relapse prevention, and 28% were referred for cognitive behavioural therapy. Additionally, 18% received prescriptions to address co-occurring psychiatric disorders, 20% were referred to local peer support groups, and 10% were facilitated to residential treatment facilities. During the 6-month follow-up, AUDIT scores decreased notably from 21 to 11. Approximately 35% of patients achieved abstinence or maintained sobriety. However, there were no significant changes in MELD-Na and Child-Pugh scores, nor in hospital admissions 6 months post-integrated care. Conclusion: The study highlights the positive impact of integrated care on patient engagement and uptake of AUD interventions among individuals with ALD, evidenced by a significant reduction in AUDIT scores and increased sobriety. An ongoing qualitative study will further evaluate patient experiences.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,003 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».