Abstract：
OBJECTIVE: It is not uncommon to encounter outpatients in the hepatology department with harmful alcohol habits. When treating such chronic liver disease (CLD) patients, an adequate intervention method for harm reduction of alcohol use, such as brief intervention (BI) or BI and nalmefene, should be considered. This study aimed to elucidate the clinical effectiveness of BI for CLD patients affected by harmful alcohol use.
METHODS: From June 2021 to 2023, 123 Japanese CLD outpatients (hepatitis B virus : hepatitis C virus : alcoholic liver disease : others = 32:18:42:31) with an Alcohol Use Disorders Identification Test (AUDIT) score of ≥8 at the initial interview and a repeat interview with AUDIT 9 months later were enrolled. Clinical features related to patient behavior following the initial AUDIT interview were retrospectively evaluated, and compared between patients without and with BI treatment.
RESULTS: For the non-BI and BI groups, baseline AUDIT score (median 10 [interquartile range (IQR) 9-13] vs. 12 [IQR 10-17], p = 0.016) and relative change in AUDIT score (median 0 [IQR -3 to 2] vs. -3 [IQR -7 to 0], p < 0.01) showed significant differences, whereas there was no significant difference between the groups for AUDIT score at the time of the second interview (p = 0.156). Following BI, significant improvements were observed for items 1, 2, 3, 4, 5, 8, and 10 of AUDIT (each p < 0.05).
CONCLUSIONS: Patients with an alcohol use disorder as well as those with alcohol dependency who received BI showed a significant decline in AUDIT score, although the score of the follow-up AUDIT indicated continued alcohol use disorder. In addition to BI, medication with nalmefene should be considered, based on individual factors.
METHODS: From June 2021 to 2023, 123 Japanese CLD outpatients (hepatitis B virus : hepatitis C virus : alcoholic liver disease : others = 32:18:42:31) with an Alcohol Use Disorders Identification Test (AUDIT) score of ≥8 at the initial interview and a repeat interview with AUDIT 9 months later were enrolled. Clinical features related to patient behavior following the initial AUDIT interview were retrospectively evaluated, and compared between patients without and with BI treatment.
RESULTS: For the non-BI and BI groups, baseline AUDIT score (median 10 [interquartile range (IQR) 9-13] vs. 12 [IQR 10-17], p = 0.016) and relative change in AUDIT score (median 0 [IQR -3 to 2] vs. -3 [IQR -7 to 0], p < 0.01) showed significant differences, whereas there was no significant difference between the groups for AUDIT score at the time of the second interview (p = 0.156). Following BI, significant improvements were observed for items 1, 2, 3, 4, 5, 8, and 10 of AUDIT (each p < 0.05).
CONCLUSIONS: Patients with an alcohol use disorder as well as those with alcohol dependency who received BI showed a significant decline in AUDIT score, although the score of the follow-up AUDIT indicated continued alcohol use disorder. In addition to BI, medication with nalmefene should be considered, based on individual factors.
摘要：
目的：在肝病科门诊患者中遇到有害的饮酒习惯并不少见。在治疗此类慢性肝病（CLD）患者时，减少饮酒危害的适当干预方法，如短暂干预(BI)或BI和纳美芬，应该考虑。本研究旨在阐明BI对受有害酒精使用影响的CLD患者的临床有效性。
方法：从2021年6月至2023年，123名日本CLD门诊患者（乙型肝炎病毒：丙型肝炎病毒：酒精性肝病：其他=32：18：42：31）在初次访谈时和9个月后的AUDIT重复访谈时，酒精使用障碍鉴定测试（AUDIT）得分≥8。回顾性评估初次AUDIT访谈后与患者行为相关的临床特征，并比较未接受BI治疗和接受BI治疗的患者。
结果：对于非BI和BI组，基线AUDIT评分(中位数10[四分位数间距(IQR)9-13]与12[IQR10-17]，p=0.016）和AUDIT评分的相对变化（中位数0[IQR-3至2]与-3[IQR-7至0]，p<0.01)显示显著差异，而在第二次访谈时，两组之间的AUDIT评分没有显着差异（p=0.156）。在BI之后,AUDIT的第1,2,3,4,5,8和10项均有显著改善(各p<0.05).
结论：患有酒精使用障碍的患者以及接受BI的酒精依赖患者的AUDIT评分显着下降，尽管AUDIT的随访评分显示持续饮酒障碍.除了BI,应考虑使用纳美芬治疗，基于个体因素。
方法：从2021年6月至2023年，123名日本CLD门诊患者（乙型肝炎病毒：丙型肝炎病毒：酒精性肝病：其他=32：18：42：31）在初次访谈时和9个月后的AUDIT重复访谈时，酒精使用障碍鉴定测试（AUDIT）得分≥8。回顾性评估初次AUDIT访谈后与患者行为相关的临床特征，并比较未接受BI治疗和接受BI治疗的患者。
结果：对于非BI和BI组，基线AUDIT评分(中位数10[四分位数间距(IQR)9-13]与12[IQR10-17]，p=0.016）和AUDIT评分的相对变化（中位数0[IQR-3至2]与-3[IQR-7至0]，p<0.01)显示显著差异，而在第二次访谈时，两组之间的AUDIT评分没有显着差异（p=0.156）。在BI之后,AUDIT的第1,2,3,4,5,8和10项均有显著改善(各p<0.05).
结论：患有酒精使用障碍的患者以及接受BI的酒精依赖患者的AUDIT评分显着下降，尽管AUDIT的随访评分显示持续饮酒障碍.除了BI,应考虑使用纳美芬治疗，基于个体因素。
