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From embedded interprofessional clinics to expanded alcohol-associated liver disease programs.

Winder GS, Arab JP, Goswami Banerjee A, Bryce K, Fipps DC, Hussain F, Im G, Omary L, Patel AA, Patel S, Rubman S, Serper M, Shenoy A, Suzuki J, Zimbrean P, Brown K, Abouljoud M, Mellinger JL. From embedded interprofessional clinics to expanded alcohol-associated liver disease programs. Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society. 2025 May 13 DOI: 10.1097/LVT.0000000000000638.

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Abstract:

Hazardous alcohol use remains a major contributor to acute and chronic liver disease while alcohol-associated liver disease (ALD) is a leading indication for liver transplantation (LT). In recent years, embedded, interprofessional ALD clinics have improved access to alcohol use disorder (AUD) care within hepatology and LT, but more work is needed to meet this challenge. The literature is lacking regarding scaling procedures to provide services for increasingly large ill patient populations. This article begins to fill this gap by describing "expanded ALD care": broad, innovative, longitudinal, interprofessional care delivery strategies surpassing standalone clinics. Drawing from analogous patient populations served by collaborative models in primary care and comprehensive eating disorder treatment, the expanded ALD care framework proposes practical strategies toward specific innovations: equipoise between biomedical and psychosocial care elements, increased clinician number and reach, long term patient relationships, harm reduction and palliative care, outreach to external agencies and clinicians, and enhanced support for patients and families. The article also defines attributes of innovative healthcare systems which support expanded ALD care.




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