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Feasibility of detection and intervention for alcohol-related liver disease in the community: the Alcohol and Liver Disease Detection study (ALDDeS)

Feasibility of detection and intervention for alcohol-related liver disease in the community: the Alcohol and Liver Disease Detection study (ALDDeS)
Feasibility of detection and intervention for alcohol-related liver disease in the community: the Alcohol and Liver Disease Detection study (ALDDeS)
Background

In the past 15 years mortality rates from liver disease have doubled in the UK. Brief alcohol advice is cost effective, but clinically meaningful reductions in alcohol consumption only occur in around 1 in 10 individuals.

Aim

To provide evidence that detecting early liver disease in the community is feasible, practical, and that feedback of liver risk can increase the proportion of subjects reducing alcohol consumption.

Design and setting

A community feasibility study in nine general practice sites in Hampshire.

Method

Hazardous and harmful drinkers were identified by WHO AUDIT questionnaire and offered screening for liver fibrosis.

Results

In total, 4630 individuals responded, of whom 1128 (24%) hazardous or harmful drinkers were offered a liver fibrosis check using the Southampton Traffic Light (STL) test; 393 (38%) attended and test results were returned by post. The STL has a low threshold for liver fibrosis with 45 (11%) red, 157 (40%) amber, and 191 (49%) green results. Follow-up AUDIT data was obtained for 303/393 (77%) and 76/153 (50%) subjects with evidence of liver damage reduced drinking by at least one AUDIT category (harmful to hazardous, or hazardous to low risk) compared with 52/150 (35%, P<0.011) subjects without this evidence; in the subset of harmful drinkers patterns (AUDIT >15), 22/34 (65%) of STL positives, reduced drinking compared with 10/29 (35%, P<0.017) STL negatives.

Conclusion

Detection of liver disease in the community is feasible, and feedback of liver risk may reduce harmful drinking.
alcohol, brief intervention, cirrhosis, liver, prevention
0960-1643
e698-e705
Sheron, Nick
cbf852e3-cfaa-43b2-ab99-a954d96069f1
Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
O'Brien, Wendy
4681130e-626d-4dcb-9785-3550f20e8e34
Harris, Scott
19ea097b-df15-4f0f-be19-8ac42c190028
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Sheron, Nick
cbf852e3-cfaa-43b2-ab99-a954d96069f1
Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
O'Brien, Wendy
4681130e-626d-4dcb-9785-3550f20e8e34
Harris, Scott
19ea097b-df15-4f0f-be19-8ac42c190028
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a

Sheron, Nick, Moore, Michael, O'Brien, Wendy, Harris, Scott and Roderick, Paul (2013) Feasibility of detection and intervention for alcohol-related liver disease in the community: the Alcohol and Liver Disease Detection study (ALDDeS). British Journal of General Practice, 63 (615), e698-e705. (doi:10.3399/bjgp13X673711).

Record type: Article

Abstract

Background

In the past 15 years mortality rates from liver disease have doubled in the UK. Brief alcohol advice is cost effective, but clinically meaningful reductions in alcohol consumption only occur in around 1 in 10 individuals.

Aim

To provide evidence that detecting early liver disease in the community is feasible, practical, and that feedback of liver risk can increase the proportion of subjects reducing alcohol consumption.

Design and setting

A community feasibility study in nine general practice sites in Hampshire.

Method

Hazardous and harmful drinkers were identified by WHO AUDIT questionnaire and offered screening for liver fibrosis.

Results

In total, 4630 individuals responded, of whom 1128 (24%) hazardous or harmful drinkers were offered a liver fibrosis check using the Southampton Traffic Light (STL) test; 393 (38%) attended and test results were returned by post. The STL has a low threshold for liver fibrosis with 45 (11%) red, 157 (40%) amber, and 191 (49%) green results. Follow-up AUDIT data was obtained for 303/393 (77%) and 76/153 (50%) subjects with evidence of liver damage reduced drinking by at least one AUDIT category (harmful to hazardous, or hazardous to low risk) compared with 52/150 (35%, P<0.011) subjects without this evidence; in the subset of harmful drinkers patterns (AUDIT >15), 22/34 (65%) of STL positives, reduced drinking compared with 10/29 (35%, P<0.017) STL negatives.

Conclusion

Detection of liver disease in the community is feasible, and feedback of liver risk may reduce harmful drinking.

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More information

Published date: October 2013
Keywords: alcohol, brief intervention, cirrhosis, liver, prevention
Organisations: Primary Care & Population Sciences, Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 345995
URI: http://eprints.soton.ac.uk/id/eprint/345995
ISSN: 0960-1643
PURE UUID: 5ac1810d-e183-4501-acf1-b9a426c2b196
ORCID for Nick Sheron: ORCID iD orcid.org/0000-0001-5232-8292
ORCID for Michael Moore: ORCID iD orcid.org/0000-0002-5127-4509
ORCID for Paul Roderick: ORCID iD orcid.org/0000-0001-9475-6850

Catalogue record

Date deposited: 28 Feb 2013 11:37
Last modified: 15 Mar 2024 03:22

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Contributors

Author: Nick Sheron ORCID iD
Author: Michael Moore ORCID iD
Author: Wendy O'Brien
Author: Scott Harris
Author: Paul Roderick ORCID iD

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