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A Randomized Controlled Trial of an Integrated Alcohol Reduction Intervention in Patients With Hepatitis C Infection.

Publication ,  Journal Article
Proeschold-Bell, RJ; Evon, DM; Yao, J; Niedzwiecki, D; Makarushka, C; Keefe, KA; Patkar, AA; Mannelli, P; Garbutt, JC; Wong, JB; Wilder, JM ...
Published in: Hepatology
June 2020

BACKGROUND AND AIMS: Hepatitis C virus (HCV) and alcohol use are patient risk factors for accelerated fibrosis progression, yet few randomized controlled trials have tested clinic-based alcohol interventions. APPROACH AND RESULTS: A total of 181 patients with HCV and qualifying alcohol screener scores at three liver center settings were randomly assigned to the following: (1) medical provider-delivered Screening, Brief Intervention, and Referral to Treatment (SBIRT), including motivational interviewing counseling and referral out for alcohol treatment (SBIRT-only), or (2) SBIRT plus 6 months of integrated colocated alcohol therapy (SBIRT + Alcohol Treatment). The timeline followback method was used to assess alcohol use at baseline and 3, 6, and 12 months. Coprimary outcomes were alcohol abstinence at 6 months and heavy drinking days between 6 and 12 months. Secondary outcomes included grams of alcohol consumed per week at 6 months. Mean therapy hours across 6 months were 8.8 for SBIRT-only and 10.1 for SBIRT + Alcohol Treatment participants. The proportion of participants exhibiting full alcohol abstinence increased from baseline to 3, 6, and 12 months in both treatment arms, but no significant differences were found between arms (baseline to 6 months, 7.1% to 20.5% for SBIRT-only; 4.2% to 23.3% for SBIRT + Alcohol Treatment; P = 0.70). Proportions of participants with any heavy drinking days decreased in both groups at 6 months but did not significantly differ between the SBIRT-only (87.5% to 26.7%) and SBIRT + Alcohol Treatment (85.7% to 42.1%) arms (P = 0.30). Although both arms reduced average grams of alcohol consumed per week from baseline to 6 and 12 months, between-treatment effects were not significant. CONCLUSIONS: Patients with current or prior HCV infection will engage in alcohol treatment when encouraged by liver medical providers. Liver clinics should consider implementing provider-delivered SBIRT and tailored alcohol treatment referrals as part of the standard of care.

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Published In

Hepatology

DOI

EISSN

1527-3350

Publication Date

June 2020

Volume

71

Issue

6

Start / End Page

1894 / 1909

Location

United States

Related Subject Headings

  • Risk Reduction Behavior
  • Risk Assessment
  • Referral and Consultation
  • Motivational Interviewing
  • Middle Aged
  • Mass Screening
  • Male
  • Liver Cirrhosis
  • Humans
  • Hepatitis C
 

Citation

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Proeschold-Bell, R. J., Evon, D. M., Yao, J., Niedzwiecki, D., Makarushka, C., Keefe, K. A., … Muir, A. J. (2020). A Randomized Controlled Trial of an Integrated Alcohol Reduction Intervention in Patients With Hepatitis C Infection. Hepatology, 71(6), 1894–1909. https://doi.org/10.1002/hep.31058
Proeschold-Bell, Rae Jean, Donna M. Evon, Jia Yao, Donna Niedzwiecki, Christina Makarushka, Kelly A. Keefe, Ashwin A. Patkar, et al. “A Randomized Controlled Trial of an Integrated Alcohol Reduction Intervention in Patients With Hepatitis C Infection.Hepatology 71, no. 6 (June 2020): 1894–1909. https://doi.org/10.1002/hep.31058.
Proeschold-Bell RJ, Evon DM, Yao J, Niedzwiecki D, Makarushka C, Keefe KA, et al. A Randomized Controlled Trial of an Integrated Alcohol Reduction Intervention in Patients With Hepatitis C Infection. Hepatology. 2020 Jun;71(6):1894–909.
Proeschold-Bell, Rae Jean, et al. “A Randomized Controlled Trial of an Integrated Alcohol Reduction Intervention in Patients With Hepatitis C Infection.Hepatology, vol. 71, no. 6, June 2020, pp. 1894–909. Pubmed, doi:10.1002/hep.31058.
Proeschold-Bell RJ, Evon DM, Yao J, Niedzwiecki D, Makarushka C, Keefe KA, Patkar AA, Mannelli P, Garbutt JC, Wong JB, Wilder JM, Datta SK, Hodge T, Naggie S, Fried MW, Muir AJ. A Randomized Controlled Trial of an Integrated Alcohol Reduction Intervention in Patients With Hepatitis C Infection. Hepatology. 2020 Jun;71(6):1894–1909.
Journal cover image

Published In

Hepatology

DOI

EISSN

1527-3350

Publication Date

June 2020

Volume

71

Issue

6

Start / End Page

1894 / 1909

Location

United States

Related Subject Headings

  • Risk Reduction Behavior
  • Risk Assessment
  • Referral and Consultation
  • Motivational Interviewing
  • Middle Aged
  • Mass Screening
  • Male
  • Liver Cirrhosis
  • Humans
  • Hepatitis C