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- (-) Alcohol Use (6)
- Behavioral Health (4)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 6 of 6 Research Studies DisplayedMcPheeters M, O'Connor EA, Riley S
Pharmacotherapy for alcohol use disorder: a systematic review and meta-analysis.
Researchers conducted a literature review and analysis to compare efficacy of therapies for alcohol use disorder. Their findings supported the use of oral naltrexone at 50 mg/d and acamprosate as first-line pharmacotherapies in conjunction with psychosocial interventions for treating alcohol use disorder.
AHRQ-funded; 75Q80120D00007.
Citation: McPheeters M, O'Connor EA, Riley S .
Pharmacotherapy for alcohol use disorder: a systematic review and meta-analysis.
JAMA 2023 Nov 7; 330(17):1653-65. doi: 10.1001/jama.2023.19761..
Keywords: Medication, Alcohol Use, Evidence-Based Practice, Patient-Centered Outcomes Research
Lee AK, Bobb JF, Richards JE
Integrating alcohol-related prevention and treatment into primary care: a cluster randomized implementation trial.
This study’s goal was to evaluate an implementation intervention to increase (1) population-based alcohol-related prevention with brief interventions and (2) treatment of alcohol use disorder (AUD) in primary care implemented with a broader program of behavioral health integration. This stepped-wedge cluster randomized trial called the Sustained Patient-Centered Alcohol-Related Care (SPARC) trial included 22 primary care practices in an integrated health system in Washington state. Participants consisted of all adult patients 18 years or older with primary care visits from January 2015 to July 2018. The study included 7 waves, with practices randomly assigned launch dates. A total of 333,596 patients visited primary care (mean age, 48 years; 193,583 [58%] female; 234,764 [70%] White individuals). The proportion of patients with brief intervention was higher during SPARC intervention than usual care periods (57 vs 11 per 10,000 patients per month). The proportion with AUD treatment engagement did not differ during intervention and usual care. However, it did increase intermediate outcomes: screening (83.2% vs 20.8%), new AUD diagnosis (33.8 vs 28.8 per 10,000), and treatment initiation (7.8 vs 6.2 per 10,000).
AHRQ-funded; HS023173.
Citation: Lee AK, Bobb JF, Richards JE .
Integrating alcohol-related prevention and treatment into primary care: a cluster randomized implementation trial.
JAMA Intern Med 2023 Apr;183(4):319-28. doi: 10.1001/jamainternmed.2022.7083.
Keywords: Alcohol Use, Substance Abuse, Behavioral Health, Primary Care, Patient-Centered Healthcare
Alexandre W, Muhammad H, Agbalajobi O
Alcohol treatment discussions and clinical outcomes among patients with alcohol-related cirrhosis.
The purpose of this study was to investigate the relationships between medical dialogues concerning alcohol use disorder (AUD) treatment, AUD treatment engagement, and mortality rates. The retrospective cohort study encompassed all patients diagnosed with cirrhosis and AUD receiving hepatology care within a single healthcare system in 2015. Baseline data on demographics, medical history, liver disease, and AUD treatment were examined. Information on AUD treatment discussions, initiation, alcohol cessation, and the subsequent 5-year mortality rates was gathered. Out of 436 patients with alcohol-related cirrhosis, 15% received AUD treatment at baseline, with 11% undergoing behavioral therapy, 2% receiving pharmacotherapy, and 1% obtaining both. Within the first year after the initial hepatology visit, 37 patients had AUD treatment, 51 remained in treatment, and 14 discontinued. Hepatology-documented AUD treatment recommendations were provided to 30% of patients, while 26% received primary care-documented recommendations. The majority of hepatology (86%) and primary care (88%) recommendations focused on behavioral therapy. Among patients with persistent alcohol use at baseline, AUD treatment after one year was significantly and independently associated with hepatology or primary care treatment discussions, and negatively associated with Medicaid insurance. When treatment discussions occurred in both settings, high treatment rates followed. Over five years, 35% of patients died. Ongoing alcohol use, age, hepatic decompensation, and hepatocellular carcinoma significantly contributed to mortality in the final survival model. In patients with alcohol-related cirrhosis, AUD treatment discussions were documented in fewer than half of hepatology and primary care encounters; however, such discussions were significantly correlated with AUD treatment receipt.
AHRQ-funded; HS019461.
Citation: Alexandre W, Muhammad H, Agbalajobi O .
Alcohol treatment discussions and clinical outcomes among patients with alcohol-related cirrhosis.
BMC Gastroenterol 2023 Feb 2; 23(1):29. doi: 10.1186/s12876-023-02656-z..
Keywords: Alcohol Use, Substance Abuse, Behavioral Health, Clinician-Patient Communication, Communication
Alkhouri N, Almomani A, Le P
The prevalence of alcoholic and nonalcoholic fatty liver disease in adolescents and young adults in the United States: analysis of the NHANES database.
The purpose of this study was to evaluate the prevalence of non-alcoholic fatty liver disease (NAFLD) and alcohol-associated fatty liver disease (ALD) in a cohort of adolescents and young adults (AYAs) using transient elastography to directly measure hepatic steatosis and suspected fibrosis. AYA’s aged 15-39 years without viral hepatitis, pregnancy, or ALT/ AST greater than 500 U/L were included in the study. The researchers compared subjects with excessive alcohol consumption to those without and found that those with excessive alcohol consumption suspected ALD was present in 56.59% and suspected significant fibrosis was present in 12.3% and suspected advanced fibrosis was present in 6.31%. In subjects without excessive alcohol consumption, suspected NAFLD was present in 40.04%. In those with suspected NAFLD, suspected significant fibrosis was present in 31.07% and suspected advanced fibrosis was present in 20.15%. The study concluded that a significant percentage of AYAs are at risk for ALD and NAFLD and a subset of these subjects is at risk for significant fibrosis.
AHRQ-funded; HS026937.
Citation: Alkhouri N, Almomani A, Le P .
The prevalence of alcoholic and nonalcoholic fatty liver disease in adolescents and young adults in the United States: analysis of the NHANES database.
BMC Gastroenterol 2022 Jul 30;22(1):366. doi: 10.1186/s12876-022-02430-7..
Keywords: Children/Adolescents, Young Adults, Alcohol Use, Chronic Conditions
Singh AN, Sanchez V, Kenzie ES
Improving screening, treatment, and intervention for unhealthy alcohol use in primary care through clinic, practice-based research network, and health plan partnerships: protocol of the ANTECEDENT study.
This study evaluates tailored implementation support to increase screening, brief intervention, referral to treatment (SBIRT) and medication-assisted treatment for alcohol use disorder (MAUD) in primary care. It will explore how primary care clinics implement SBIRT and MAUD in routine practice and how practice facilitators vary implementation support across diverse clinic settings. It is anticipated that findings will inform how effectively to align implementation support to context, advance understanding of practice facilitator skill development over time, and ultimately improve detection and treatment of unhealthy alcohol use across diverse primary care clinics.
AHRQ-funded; HS027080.
Citation: Singh AN, Sanchez V, Kenzie ES .
Improving screening, treatment, and intervention for unhealthy alcohol use in primary care through clinic, practice-based research network, and health plan partnerships: protocol of the ANTECEDENT study.
PLoS One 2022 Jun 28;17(6):e0269635. doi: 10.1371/journal.pone.0269635..
Keywords: Alcohol Use, Substance Abuse, Behavioral Health, Primary Care, Care Management
Lin Y, Sharma B, Thompson HM
External validation of a machine learning classifier to identify unhealthy alcohol use in hospitalized patients.
This study’s objective was to validate a machine learning approach to alcohol screening using a natural language processing (NLP) classifier developed at an independent medical center. This retrospective cohort study took place at a midwestern US tertiary-care, urban medical center that has an inpatient structured universal screening model for unhealthy substance use and an active addiction consult service. The cohort included 57,605 unplanned admissions of adult patients between October 23, 2017 and December 31, 2019 with electronic health record (EHR) documentation of manual alcohol screening. The authors examined error in manual screening and reviewed discordance between the NLP classifier and AUDIT-derived reference. The classifier demonstrated adequate sensitivity and specificity for routine clinical use as an automated screening tool for identifying at-risk patients.
AHRQ-funded; HS026385.
Citation: Lin Y, Sharma B, Thompson HM .
External validation of a machine learning classifier to identify unhealthy alcohol use in hospitalized patients.
Addiction 2022 Apr;117(4):925-33. doi: 10.1111/add.15730..
Keywords: Alcohol Use, Behavioral Health, Screening, Electronic Health Records (EHRs), Health Information Technology (HIT)