Computer-delivered brief alcohol intervention for patients with liver disease: a randomized controlled trial.

Cucciare MA, Combs AS, Joshi G, Han X, Humphreys K. Computer-delivered brief alcohol intervention for patients with liver disease: a randomized controlled trial. Addiction (Abingdon, England). 2021 May 1; 116(5):1076-1087.

Related HSR&D Project(s)

• RCS 04-141 – Evaluating Treatment & Self-help Methods of Improving Functioning & Quality of Life Outcomes of Patients with Substance Abuse Disorders
• CRE 12-009 – Web-based Intervention to Reduce Alcohol Use in Veterans with Hepatitis C

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Abstract:

BACKGROUND AND AIMS: Reducing alcohol consumption by liver disease patients can reduce morbidity and mortality. This study compared a computer-delivered brief alcohol intervention (cBAI) with standard care in a sample of US military veterans with liver disease. DESIGN: Multi-site, randomized controlled trial of a cBAI plus standard care (n  =  67) versus standard care only (n  =  71). Participants were assessed at baseline and 3- and 6-month follow-up. SETTING: US Veterans Health Administration liver clinics. PARTICIPANTS: Participants were mostly male and diagnosed with hepatitis C. INTERVENTIONS AND COMPARATORS: A cBAI tailored to veterans with liver disease and consisting of assessment and personalized feedback. Standard care was brief education and advice about alcohol and liver disease. MEASUREMENT: Primary outcomes were self-reported number of drinking days and unhealthy drinking days (defined as more than two drinks for men and more than one for women) in the past 30 days at 6-month follow-up. Secondary outcomes were these two variables at 3-month follow-up, and drinks consumed per drinking day, depression and overall health at 3- and 6-month follow-ups. Missing data were imputed using multiple imputation. FINDINGS: Compared with standard care, cBAI participants reported significantly fewer drinking days at 6-month follow-up and fewer unhealthy drinking days at both 3- and 6-month follow-ups. Least square means (LS-means) for number of drinking days were 3.78 for the cBAI condition and 6.89 for the standard care condition at 6 months [LS-mean ratio  =  3.78/6.89  =  0.55, 95% confidence interval (CI)  =  0.34, 0.89]. LS-means for number of unhealthy drinking days were 1.04 for the cBAI condition and 2.57 for the standard care condition at 3-month follow-up (LS-mean ratio  =  1.04/2.57  =  0.41, 95% CI  =  0.19, 0.85). At 6-months follow-up, LS-means were 1.18 for the cBAI condition and 2.75 for the standard care condition (LS-mean ratio  =  1.18/2.75  =  0.43, 95% CI  =  0.20, 0.91). CONCLUSIONS: A computer-delivered brief alcohol intervention reduced drinking days and unhealthy drinking days at 6-month follow up in military veterans with liver disease compared with brief education and advice to reduce consumption.