Multidisciplinary Care of Alcohol-Related Liver Disease and Alcohol Use Disorder: A Narrative Review for Hepatology and Addiction Clinicians

Clin Ther. 2023 Oct 7:S0149-2918(23)00381-8. doi: 10.1016/j.clinthera.2023.09.016. Online ahead of print.ABSTRACTPURPOSE: Models of integrated, multidisciplinary care are optimal in the setting of complex, chronic diseases and in the overlap of medical and mental health disease, both of which apply to alcohol-related liver disease (ALD). Alcohol use disorder (AUD) drives nearly all cases of ALD, and coexisting mental health disease is common. ALD is a complex condition with severe clinical manifestations and high mortality that can occasionally lead to liver transplantation. As a result, integrated care for ALD is an attractive proposition. The aim of this narrative review was to: (1) review the overlapping and concerning trends in the epidemiology of AUD and ALD; (2) use a theoretical framework for integrated care known as the "five-component model" as a basis to highlight the need for integrated care and the overlapping clinical manifestations and management of the 2 conditions; and (3) review the existing applications of integrated care in this area.METHODS: We performed a narrative review of epidemiology, clinical manifestations, and management strategies in AUD and ALD, with a particular focus on areas of overlap that are pertinent to clinicians who manage each disease. Previously published models were reviewed for integrating care in AUD and ALD, both in the general ALD population and in the setting of liver transplantation.FINDINGS: The incidences of AUD and ALD are ri...
Source: Clinical Therapeutics - Category: Drugs & Pharmacology Authors: Source Type: research