Transient Elastography Increases Readiness for Change in Inpatients With Alcohol Use Disorder: The ELISA Pilot Study

IF 2.6 3区 医学 Q3 BIOCHEMISTRY & MOLECULAR BIOLOGY
Stephanie M. Rutledge, Rohit R. Nathani, Patricia Miguez Arosemena, Daniel Suter, David Lehman, Timothy Brennan, Gene Y. Im
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Abstract

Opportunistic interventions (OIs) are health events facilitated by healthcare providers through education that can motivate individuals to adopt risk-reducing behaviours. Our aim was to evaluate transient elastography (TE) as an OI in patients with AUD by assessing changes in validated psychometric scores (PS) of alcohol insight and readiness for change. In this prospective, proof-of-concept pilot study, patients with AUD without TE in the past year were enrolled from an inpatient addiction unit. At baseline, three PS assessing insight and readiness to change were administered: Hanil Alcohol Insight Scale (HAIS), revised Readiness Ruler (RR) and Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES-8A). TE was performed, interpreted, and followed by repeat PS testing. The primary outcome was change in PS. Secondary outcomes were prevalence of fibrosis and steatosis on TE, alcohol use and linkage to hepatology care. From 4 January 2022 to 4 January 2023, 23 patients were enrolled: mean age: 51 years (SD ± 12), 74% male, 61% White and all with severe AUD, and mean of 20 (± 9) daily drinks, 286 g (± 127 g) or 35.7 (± 15.9) units of alcohol, for a median of 14 years (IQR 10–21.5). After TE, there were significant increases in revised RR and SOCRATES-8A from 5 to 8.6 (± 2.1, p < 0.01) and 81.5 to 85.0 (± 8.0, p = 0.04), respectively, indicating improved motivation and readiness for change. HAIS did not change: 11.1–11.0 (± 3, p = 0.36). Cirrhosis and steatosis grade ≥ 2 were detected in 4/23 (17%) and 8/23 (35%), respectively. In this pilot study, performing and interpreting results of TE to inpatients with AUD increase readiness for change and efficiently detects advanced fibrosis.

Abstract Image

瞬态弹性成像增加住院患者对酒精使用障碍改变的准备:ELISA试点研究
机会性干预是由卫生保健提供者通过教育促进的健康事件,可以激励个人采取减少风险的行为。我们的目的是通过评估酒精洞察力和改变准备度的有效心理测量分数(PS)的变化来评估短暂弹性成像(TE)作为AUD患者的OI。在这项前瞻性的、概念验证的试点研究中,过去一年中没有TE的AUD患者从住院成瘾病房入组。在基线时,使用三个评估洞察力和改变准备程度的PS: Hanil酒精洞察力量表(HAIS),修订的准备程度尺(RR)和变化准备程度和治疗渴望程度量表(SOCRATES-8A)。TE被执行,解释,然后重复PS测试。主要结局是PS的改变。次要结局是TE的纤维化和脂肪变性患病率、酒精使用以及与肝病治疗的联系。从2022年1月4日至2023年1月4日,纳入了23例患者:平均年龄:51岁(SD±12),74%男性,61%白人,均患有严重AUD,平均每天饮酒20(±9)次,286 g(±127 g)或35.7(±15.9)单位酒精,中位时间为14年(IQR 10-21.5)。TE后,修订后的RR和SOCRATES-8A分别从5到8.6(±2.1,p < 0.01)和81.5到85.0(±8.0,p = 0.04)显著增加,表明改变的动机和准备程度有所提高。HAIS无变化:11.1 ~ 11.0(±3,p = 0.36)。肝硬化和脂肪变性≥2级的分别为4/23(17%)和8/23(35%)。在这项初步研究中,对住院AUD患者进行TE检查并解释其结果,增加了患者对改变的准备,并有效地检测了晚期纤维化。
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来源期刊
Addiction Biology
Addiction Biology 生物-生化与分子生物学
CiteScore
8.10
自引率
2.90%
发文量
118
审稿时长
6-12 weeks
期刊介绍: Addiction Biology is focused on neuroscience contributions and it aims to advance our understanding of the action of drugs of abuse and addictive processes. Papers are accepted in both animal experimentation or clinical research. The content is geared towards behavioral, molecular, genetic, biochemical, neuro-biological and pharmacology aspects of these fields. Addiction Biology includes peer-reviewed original research reports and reviews. Addiction Biology is published on behalf of the Society for the Study of Addiction to Alcohol and other Drugs (SSA). Members of the Society for the Study of Addiction receive the Journal as part of their annual membership subscription.
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