Study Highlights Traits of Patients with Alcohol-Associated Cirrhosis Seeking Treatment

Individuals with alcohol-associated cirrhosis who have anxiety/depression and are younger are more likely to implement alcohol use disorder (AUD) treatment, new findings suggest.¹

These data also suggest that implementing targeted outreach and the integration of alcohol-associated liver disease (ALD) and AUD may be necessary. Jeremy W. Luk, from the office of the clinical director at the National Institute on Alcohol Abuse and Alcoholism in Maryland, led the analysis that resulted in these findings.

Luk and colleagues noted the importance of identifying and treating AUD among those who have ALD, highlighting recent research into ALD suggesting that prior history of treatment, younger age, and co-occurring depression or AUD may be linked with AUD treatment utilization.^2,3 However, such findings are not helpful for understanding the role of quality of life in the process of AUD recovery.

“Addressing this gap, we aim to examine patient demographic and clinical factors, as well as liver disease quality of life, in relation to patient-reported utilization of lifetime and past 12-month pharmacological and behavioral AUD treatment among socioeconomically disadvantaged patients with alcohol-associated cirrhosis,” Luk and colleagues wrote.¹

Study Details

The study involved individuals with cirrhosis receiving care at hepatology specialty clinics of 3 academic medical centers, including 2 Veterans Affairs (VA) facilities and a public safety-net hospital. Participants were enrolled between February 2022 and February 2023.

Inclusion criteria included:

* Age 18 years or older
* Clinical diagnosis of cirrhosis
* Proficiency in English or Spanish

Participants completed a one-time interviewer-administered questionnaire assessing liver disease quality of life (LDQoL), alcohol use disorder (AUDIT), demographics, self-reported mental health symptoms, and history of AUD treatment utilization.

Key Findings

The study found:

* 88% of the 196 participants were male, with a mean age of 62 years.
* 67% had reported ever utilizing AUD treatment, and 32% reported using it within the past 12 months.
* Participants who used AUD treatment, both lifetime and past 12 months, were younger, had lower LDQoL scores, and reported higher levels of anxiety, depression, and problematic drinking.
* Older age and higher LDQoL scores were associated with lower odds of using pharmacological AUD treatment.
* Individuals with a history of anxiety or depression had higher odds of AUD treatment utilization.
* Older age was associated with lower odds of past 12-month AUD treatment use, while current anxiety/depression and problematic drinking were linked with higher odds.

“These findings underscore the importance of using validated assessment tools like GAD-7, PHQ-8, and AUDIT to screen for symptoms of anxiety and depression, as well as problematic drinking,” they wrote. “Integrating these assessments into hepatology practices can facilitate tailored interventions and referrals to behavioral health and AUD treatment services.”¹

** References:**

1. ^{Luk, J.W., Ha, N.B., Shui, A.M., Snyder, H.R., Batki, S.L., Ostacher, M.J. et al. (2024) Demographic and clinical characteristics associated with utilization of alcohol use disorder treatment in a multicenter study of patients with alcohol-associated cirrhosis. Alcohol: Clinical and Experimental Research, 00, 1–12. Available from: https://doi.org/10.1111/acer.15500.}
2. ^{Thompson, M.F., Schwandt, M.L., Ramchandani, V.A., Diazgranados, N., Goldman, D. & Luk, J.W. (2024) Stress and alcohol-related coping mechanisms linking lifetime suicide ideation and attempt to multidimensional quality of life. Journal of Affective Disorders, 351, 729–737. Available from: https://doi.org/10.1016/j.jad.2024.01.209.}
3. ^{Luk, J.W., Ramchandani, V.A., Diazgranados, N., Schwandt, M.L., Gunawan, T., George, D.T. et al. (2022) Multidimensional quality of life across the Spectrum of alcohol use behavior. Psychiatric Research and Clinical Practice, 4(4), 92–101. Available from: https://doi.org/10.1176/appi.prcp.20220023.}

This research highlights the need for increased awareness and targeted interventions to address AUD among individuals with ALD.

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