From detection to intervention, optimizing care for patients with alcohol use disorder and advanced hepatic fibrosis DOI Creative Commons
Paola Zuluaga, Suthat Liangpunsakul

Alcohol Clinical and Experimental Research, Год журнала: 2024, Номер 48(12), С. 2253 - 2255

Опубликована: Окт. 27, 2024

Nearly half of the world's population consumes alcohol, with approximately 20% engaging in binge drinking and 5%–10% excessively over long term (Manthey et al., 2019). Alcohol consumption is a leading cause liver disease mortality both United States Europe, contributing to significant public health burden (Karlsen 2022). The risk developing alcohol-associated (ALD) varies widely among individuals, influenced by factors such as genetics (Schwantes-An 2024; Yuan 2024), socioeconomic status (Askgaard 2021), specific patterns (Aberg 2017). Additionally, stigma surrounding heavy complicates accurate tracking alcohol intake, underreporting misdiagnosis (Schomerus Unlike many other diseases, ALD often diagnosed late, typically after serious complications from portal hypertension or advanced fibrosis have developed (Shah progression drinkers heterogeneous; while some individuals develop severe problems rapidly, others may experience slower remain relatively unaffected for years (Israelsen 2024). Noninvasive tests (NITs) play crucial role identifying high-risk patients who require intervention, distinguishing them those at lower Early detection through NITs focuses on two critical scenarios: screening at-risk diagnosing predicting outcomes Liver fibrosis, key predictor failure asymptomatic patients, can be assessed using various methods These include elastography-based tools stiffness measurement (LSM) blood-based markers fibrosis-4 test (FIB-4) While LSM provides valuable insights into stiffness, its availability limited, particularly nonspecialist settings, which restricts use routine early In contrast, biomarkers FIB-4 offer more convenient accessible option screening, allowing easier implementation healthcare settings Patients excessive (EAU) disorder (AUD) represent ALD, primarily due their significantly elevated damage. Prolonged lead development rendering AUD susceptible diseases. Our recent study has highlighted urgency this issue, demonstrating that one five admitted treatment exhibits values indicative (Zuluaga Screening essential, it enables identification initial stages, timely interventions reduce complications. October 2024 issue ACER, Houston al. (2024) examined whether EAU high scores are being appropriately referred hepatology. Analyzing records 1131 large system between 2013 2023, they found only 37% 316 active were hepatology (Houston alcohol-related mental issues trauma less likely receive referrals, hospitalizations higher comorbidity Alarmingly, nearly 63% not care need valuable, but effectiveness depends actions taken following results. Identifying just step; essential providers implement appropriate follow-up address these findings effectively. success initiatives relies coordinated approach emphasizes also importance clinical responses. This includes making prompt referrals specialists, comprehensive management plans, implementing targeted tailored each patient's needs. Without actions, efforts fail translate meaningful improvements patient outcomes. According (2024), despite awareness disease, referral rates services alarmingly low. trend pronounced trauma, frequently miss out evaluations Several contribute concerning issue. First, prioritize immediate needs potential issues, especially emergency inpatient settings. acute focus psychiatric physical crises overshadow assessing underlying (Johnson As result, overlooked, missed opportunities referrals. Second, primary unfamiliar noninvasive score liver-related risks associated knowledge gap result an underestimation severity recognize necessity specialized care. Third, conditions introduce biases (Ahad 2023). Providers might unconsciously view having urgent medical concerns, diminishes emphasis conducting screenings disease. present clear complications, Finally, systemic fragmented models inadequate communication care, health, further exacerbate challenges facilitating (McGinty & Daumit, 2020; Zuchowski 2015). To enhance within multifaceted essential. begins increasing education training emphasizing pathophysiology score. Implementing integrated foster collaboration vital (Winder Such facilitate regular ensuring prioritized standardized protocols assessments during visits streamline individuals. Utilizing electronic flag will process (Khan Engaging about paramount. Empowering advocate well-being greater involvement encourage seek screenings. Establishing robust results specialty improving (Seyed-Nezhad 2021). providers, without unnecessary delays (Sheehan Furthermore, continuous quality improvement framework monitor processes (Hill 2020). By collecting analyzing data rates, patterns, outcomes, identify areas inform ongoing policy adjustments sheds light improved practices fibrosis. low services, research underscores integrating gained interventions, enhanced utilization tools. addressing gaps fostering we improve AUD, better work supported part U01AA026917, UH3AA026903, R01AA030312 NIH/NIAAA; Department Veterans Affairs Merit Award I01CX000361 I01BX006202; Dean's Scholar Indiana University School Medicine (SL); JR20/00016 RD21/0009/0004 Instituto de Salud Carlos III; Centres Recerca Catalunya 2021-SGR-00945. None.

Язык: Английский

From detection to intervention, optimizing care for patients with alcohol use disorder and advanced hepatic fibrosis DOI Creative Commons
Paola Zuluaga, Suthat Liangpunsakul

Alcohol Clinical and Experimental Research, Год журнала: 2024, Номер 48(12), С. 2253 - 2255

Опубликована: Окт. 27, 2024

Nearly half of the world's population consumes alcohol, with approximately 20% engaging in binge drinking and 5%–10% excessively over long term (Manthey et al., 2019). Alcohol consumption is a leading cause liver disease mortality both United States Europe, contributing to significant public health burden (Karlsen 2022). The risk developing alcohol-associated (ALD) varies widely among individuals, influenced by factors such as genetics (Schwantes-An 2024; Yuan 2024), socioeconomic status (Askgaard 2021), specific patterns (Aberg 2017). Additionally, stigma surrounding heavy complicates accurate tracking alcohol intake, underreporting misdiagnosis (Schomerus Unlike many other diseases, ALD often diagnosed late, typically after serious complications from portal hypertension or advanced fibrosis have developed (Shah progression drinkers heterogeneous; while some individuals develop severe problems rapidly, others may experience slower remain relatively unaffected for years (Israelsen 2024). Noninvasive tests (NITs) play crucial role identifying high-risk patients who require intervention, distinguishing them those at lower Early detection through NITs focuses on two critical scenarios: screening at-risk diagnosing predicting outcomes Liver fibrosis, key predictor failure asymptomatic patients, can be assessed using various methods These include elastography-based tools stiffness measurement (LSM) blood-based markers fibrosis-4 test (FIB-4) While LSM provides valuable insights into stiffness, its availability limited, particularly nonspecialist settings, which restricts use routine early In contrast, biomarkers FIB-4 offer more convenient accessible option screening, allowing easier implementation healthcare settings Patients excessive (EAU) disorder (AUD) represent ALD, primarily due their significantly elevated damage. Prolonged lead development rendering AUD susceptible diseases. Our recent study has highlighted urgency this issue, demonstrating that one five admitted treatment exhibits values indicative (Zuluaga Screening essential, it enables identification initial stages, timely interventions reduce complications. October 2024 issue ACER, Houston al. (2024) examined whether EAU high scores are being appropriately referred hepatology. Analyzing records 1131 large system between 2013 2023, they found only 37% 316 active were hepatology (Houston alcohol-related mental issues trauma less likely receive referrals, hospitalizations higher comorbidity Alarmingly, nearly 63% not care need valuable, but effectiveness depends actions taken following results. Identifying just step; essential providers implement appropriate follow-up address these findings effectively. success initiatives relies coordinated approach emphasizes also importance clinical responses. This includes making prompt referrals specialists, comprehensive management plans, implementing targeted tailored each patient's needs. Without actions, efforts fail translate meaningful improvements patient outcomes. According (2024), despite awareness disease, referral rates services alarmingly low. trend pronounced trauma, frequently miss out evaluations Several contribute concerning issue. First, prioritize immediate needs potential issues, especially emergency inpatient settings. acute focus psychiatric physical crises overshadow assessing underlying (Johnson As result, overlooked, missed opportunities referrals. Second, primary unfamiliar noninvasive score liver-related risks associated knowledge gap result an underestimation severity recognize necessity specialized care. Third, conditions introduce biases (Ahad 2023). Providers might unconsciously view having urgent medical concerns, diminishes emphasis conducting screenings disease. present clear complications, Finally, systemic fragmented models inadequate communication care, health, further exacerbate challenges facilitating (McGinty & Daumit, 2020; Zuchowski 2015). To enhance within multifaceted essential. begins increasing education training emphasizing pathophysiology score. Implementing integrated foster collaboration vital (Winder Such facilitate regular ensuring prioritized standardized protocols assessments during visits streamline individuals. Utilizing electronic flag will process (Khan Engaging about paramount. Empowering advocate well-being greater involvement encourage seek screenings. Establishing robust results specialty improving (Seyed-Nezhad 2021). providers, without unnecessary delays (Sheehan Furthermore, continuous quality improvement framework monitor processes (Hill 2020). By collecting analyzing data rates, patterns, outcomes, identify areas inform ongoing policy adjustments sheds light improved practices fibrosis. low services, research underscores integrating gained interventions, enhanced utilization tools. addressing gaps fostering we improve AUD, better work supported part U01AA026917, UH3AA026903, R01AA030312 NIH/NIAAA; Department Veterans Affairs Merit Award I01CX000361 I01BX006202; Dean's Scholar Indiana University School Medicine (SL); JR20/00016 RD21/0009/0004 Instituto de Salud Carlos III; Centres Recerca Catalunya 2021-SGR-00945. None.

Язык: Английский

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