Barriers to the management of alcohol use disorder and alcohol-associated liver disease: strategies to implement integrated care models

2022 ◽  
Vol 7 (2) ◽  
pp. 186-195
Author(s):  
Andrea F DiMartini ◽  
Lorenzo Leggio ◽  
Ashwani K Singal
Keyword(s):  
Liver Disease ◽  
Alcohol Use ◽  
Integrated Care ◽  
Alcohol Use Disorder ◽  
Care Models ◽  
Integrated Care Models

Serum HMGB1 Associates with Liver Disease and Predicts Readmission and Mortality in Patients with Alcohol Use Disorder

Alcohol ◽  
2021 ◽  
Author(s):  
Augustin G.L. Vannier ◽  
Ben Wardwell ◽  
Vladislav Fomin ◽  
Amanda Pebenito ◽  
Nicholas Wolczynski ◽  
...  
Keyword(s):  
Liver Disease ◽  
Alcohol Use ◽  
Alcohol Use Disorder

scholarly journals Dynamic Changes of the Fungal Microbiome in Alcohol Use Disorder

2021 ◽  
Vol 12 ◽  
Author(s):  
Phillipp Hartmann ◽  
Sonja Lang ◽  
Suling Zeng ◽  
Yi Duan ◽  
Xinlian Zhang ◽  
...  
Keyword(s):  
Liver Disease ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Serum Levels ◽  
Amplicon Sequencing ◽  
Dynamic Changes ◽  
Alcohol Abstinence ◽  
Liver Health ◽  
Fungal Microbiome ◽  
Progressive Liver Disease

BackgroundAlcohol-associated liver disease (ALD) is an important cause of morbidity and mortality worldwide. The intestinal microbiota is involved in the development and progression of ALD; however, little is known about commensal fungi therein.MethodsWe studied the dynamic changes of the intestinal fungal microbiome, or mycobiome, in 66 patients with alcohol use disorder (AUD) and after 2 weeks of alcohol abstinence using internal transcribed spacer 2 (ITS2) amplicon sequencing of fecal samples.ResultsPatients with AUD had significantly increased abundance of the genera Candida, Debaryomyces, Pichia, Kluyveromyces, and Issatchenkia, and of the species Candida albicans and Candida zeylanoides compared with control subjects. Significantly improved liver health markers caspase-cleaved and intact cytokeratin 18 (CK18-M65) levels and controlled attenuation parameter (CAP) in AUD patients after 2 weeks of alcohol abstinence were associated with significantly lower abundance of the genera Candida, Malassezia, Pichia, Kluyveromyces, Issatchenkia, and the species C. albicans and C. zeylanoides. This was mirrored by significantly higher specific anti-C. albicans immunoglobulin G (IgG) and M (IgM) serum levels in AUD patients in relation to control participants, and significantly decreased anti-C. albicans IgG levels in AUD subjects after 2 weeks of abstinence. The intestinal abundance of the genus Malassezia was significantly higher in AUD subjects with progressive liver disease compared with non-progressive liver disease.ConclusionIn conclusion, improved liver health in AUD patients after alcohol abstinence was associated with lower intestinal abundances of Candida and Malassezia, and lower serum anti-C. albicans IgG levels. Intestinal fungi might serve as a therapeutic target to improve the outcome of patients in ALD.

scholarly journals Impact of Relaxation and Group Psycho-Education on Health Outcomes Using Integrated Care Models and Quality Improvement

2014 ◽  
Vol 04 (12) ◽  
pp. 887-896 ◽  
Author(s):  
Martha Okafor ◽  
Victor Ede ◽  
Rosemary Kinuthia ◽  
Debbie Strotz ◽  
Cathryn Marchman ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Health Outcomes ◽  
Integrated Care ◽  
Care Models ◽  
Integrated Care Models

Lifetime drinking history in patients with alcoholic liver disease and patients with alcohol use disorder without liver disease

2017 ◽  
Vol 52 (6-7) ◽  
pp. 762-767 ◽  
Author(s):  
Jon Kristinn Nielsen ◽  
Sigurdur Olafsson ◽  
Ottar M. Bergmann ◽  
Valgerdur Runarsdottir ◽  
Ingunn Hansdottir ◽  
...  
Keyword(s):  
Liver Disease ◽  
Alcohol Use ◽  
Alcoholic Liver Disease ◽  
Alcohol Use Disorder ◽  
Drinking History

Executive Functioning Moderates Responses to Appetitive Cues: A Study in Severe Alcohol Use Disorder and Alcoholic Liver Disease

2018 ◽  
Vol 54 (1) ◽  
pp. 38-46 ◽  
Author(s):  
Warren B Logge ◽  
Kirsten C Morley ◽  
Paul S Haber ◽  
Andrew J Baillie
Keyword(s):  
Liver Disease ◽  
Alcohol Use ◽  
Executive Functioning ◽  
Alcoholic Liver Disease ◽  
Alcohol Use Disorder ◽  
Appetitive Cues

Confronting the Crisis of Comorbid Alcohol Use Disorder and Alcohol-Related Liver Disease With a Novel Multidisciplinary Clinic

2020 ◽  
Vol 61 (3) ◽  
pp. 238-253
Author(s):  
Gerald Scott Winder ◽  
Anne C. Fernandez ◽  
Kristin Klevering ◽  
Jessica L. Mellinger
Keyword(s):  
Liver Disease ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Multidisciplinary Clinic ◽  
Related Liver Disease

Effectiveness and cost-effectiveness of integrated care models for elderly, complex patients: A narrative review. Don’t we need a value-based approach?

2018 ◽  
Vol 21 (4) ◽  
pp. 120-139 ◽  
Author(s):  
Marta Marino ◽  
Antonio G de Belvis ◽  
Maria Tanzariello ◽  
Emanuele Dotti ◽  
Sabina Bucci ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Health Outcomes ◽  
Integrated Care ◽  
Service Providers ◽  
Systems Of Care ◽  
Social Needs ◽  
Narrative Review ◽  
A Value ◽  
Care Models ◽  
Integrated Care Models

Introduction The management of patients with complex health and social needs is one of the main challenges for healthcare systems. Integrated care seems to respond to this issue, with collaborative working and integration efforts of the care system components professionals and service providers aimed at improving efficiency, appropriateness and person centeredness of care. We conducted a narrative review to analyse the available evidences published on effectiveness and cost-effectiveness of integrated care models targeted on the management of such elderly patients. Methods MEDLINE, Scopus and EBSCO were searched. We reported this narrative review according to the PRISMA Checklist. For studies to be included, they had to: (i) refer to integrated care models through implemented experimental or demonstration projects; (ii) focus on frail elderly ≥65 years old, with complex health and social needs, not disease-specific; (iii) evaluate effectiveness and/or cost and/or cost-effectiveness; (iv) report quantitative data (e.g. health outcomes, utilization outcomes, cost and cost-effectiveness). Results Thirty articles were included, identifying 13 integrated care models. Common features were identified in case management, geriatric assessment and multidisciplinary team. Favourable impacts on healthcare facilities utilization rates, though with mixed results on costs, were found. The development of community-based and cost-effective integrated systems of care for the elderly is possible, thanks to the cooperation across care professionals and providers, to achieving a relevant impact on healthcare and efficient resource management. The elements of success or failure are not always unique and identifiable, but the potential clearly exists for these models to be successful and generalized on a large scale. Discussion We found out a favourable impact of integrated care models/methods on health outcomes, care utilization and costs. The selected interventions are likely to be implemented at community level, focused on the patient management in terms of continuity of care. Thus, we propose a value-based framework for the evaluation of these services.

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