Integrated Care of Alcohol-Related Liver Disease

• Published in: Journal of clinical and experimental hepatology Vol. 12; no. 4; pp. 1069 - 1082
• Main Authors: Winder, Gerald S., Fernandez, Anne C., Mellinger, Jessica L.
• Format: Journal Article
• Language: English
• Published: India Elsevier B.V 01.07.2022; Elsevier
• Subjects: alcohol; integrated; interprofessional; liver; multidisciplinary; Original; alcohol; AUD; multidisciplinary; SUD; interprofessional; liver; LT; QI; ALD; integrated; LT, liver transplantation; SUD, substance use disorder; ALD, alcohol-related liver disease; QI, quality improvement; AUD, alcohol use disorder
• ISSN: 0973-6883; 2213-3453
• DOI: 10.1016/j.jceh.2022.01.010

Alcohol-related liver disease (ALD) is the medical manifestation of alcohol use disorder, a prevalent psychiatric condition. Acute and chronic manifestations of ALD have risen in recent years especially in young people and ALD is now a leading indication of liver transplantation (LT) worldwide. Such alarming trends raise urgent and unanswered questions about how medical and psychiatric care can be sustainably integrated to better manage ALD patients before and after LT. Critical evaluation of the interprofessional implications of broad and multifaceted ALD pathophysiology, general principles of and barriers to interprofessional teamwork and care integration, and measures that clinicians and institutions can implement for improved and integrated ALD care. The breadth of ALD pathophysiology, and its numerous medical and psychiatric comorbidities, ensures that no single medical or psychiatric discipline is adequately trained and equipped to manage the disease alone. Early models of feasible ALD care integration have emerged in recent years but much more work is needed to develop and study them. The future of ALD care is an integrated approach led jointly by interprofessional medical and psychiatric clinicians.