Coronavirus Disease 2019 (Covid-19) Impact on Alcohol-related Liver Disease Patient Outcomes, Care and Alcohol Use
Liver Diseases, Alcohol Use Disorder
About this trial
This is an interventional treatment trial for Liver Diseases
Eligibility Criteria
Inclusion criteria:
- Men and women age ≥ 18 years.
- Diagnosis of chronic liver disease (CLD).
- Unhealthy alcohol use, defined as more than moderate amount of alcohol use within the prior 30 days by National Institute on Alcohol Abuse and Alcoholism (NIAAA) criteria defined as on average more than 1 drink/day (7 drinks per week) for women and more than 2 drinks per day (14 drinks per week) for men, or on average at least one heavy drinking day (4+ drinks in a day for women and 5+ for men) per week in the prior 30 days. A standard drink is ~14 g of alcohol.
- Ability to access a telephone or a digital device (i.e., computer, tablet or smart phone).
Exclusion criteria:
- Severe medical or psychiatric conditions or evidence of acute alcohol intoxication preventing participation in the study
- Are currently enrolled in formal treatment for unhealthy alcohol use, excluding self or mutual-help groups (e.g., Alcoholics Anonymous).
- Women who are pregnant or breastfeeding or unwilling to use birth control.
- Language preference other than English or Spanish.
- Unwilling or unable to provide informed consent.
Sites / Locations
- University of california San Francisco
- Zuckerberg San Francisco General HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Stepped alcohol intervention (SAT) to reduce unhealthy alcohol use
Usual Care (UC)
For participants randomized to SAT, consistent with stepped care, treatment will begin with lower intensity services that are stepped up, if necessary, at a predefined time point. Step 1 consists of three motivational interviewing (MI)sessions delivered every 2 weeks. At the 3-month assessment, those with non-response to MI, defined as continued unhealthy alcohol use in the prior 14 days, will be referred to on site physician managed addiction specialty services (Step 2) for higher intensity services.
UC participants will receive their usual services in hepatology. They will also be given publicly available patient education materials regarding risk associated with unhealthy drinking (mail/email or in-person if desired) and will be asked to follow up with their physician should they have questions about information provided in the handouts. UC participants' hepatology provider will be notified if AUDIT-C scores are greater than 3 at baseline. All UC participants will have access to alcohol and other substance use treatment available to patients at their respective sites.