Original articleSystematic reviews and meta-analysesEfficacy of Psychosocial Interventions in Inducing and Maintaining Alcohol Abstinence in Patients With Chronic Liver Disease: A Systematic Review
Section snippets
Methods
We conducted our systematic review in accordance with the PRISMA guidelines18 including use of an a priori designed study protocol that guided our literature search, study selection, and data synthesis.
Study Selection
We screened 3055 potentially eligible studies and then examined in detail 32 full-text articles. Of these, we excluded 19 studies. The most common reasons for ineligibility of reviewed studies were inability to report alcohol abstinence as an outcome (N = 8) or lack of inclusion of patients with CLD (N = 6) (Figure 1).
Study Characteristics
We included 5 RCTs21, 22, 23, 24, 25 and 8 non-randomized or observational studies (N = 2 non-randomized cohort studies with historical control groups26, 27 and N = 6 uncontrolled
Discussion
Substantial evidence exists to support the use of non-integrated, stand-alone psychosocial interventions in treating AUD in non-CLD population.16, 34, 35 Our systematic review suggests that integrated combination psychotherapy with CBT, MET, and comprehensive medical care may increase alcohol abstinence in patients with CLD and AUD. Most other interventions did not impact induction of abstinence in patients with CLD. We also found that therapies that used integrated care resulted in better
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This article has an accompanying continuing medical education activity on page e20. Learning Objective–Upon completion of this activity, successful learners should be able to determine that psychosocial interventions that are integrated with medical care are most efficacious in inducing and maintaining alcohol abstinence in patients with chronic liver disease and alcohol use disorder.
Conflicts of interest The authors disclose no conflicts.
Funding This research was supported in part by the Houston Veterans Affairs Health Services Research Center of Innovations (CIN13-413), Texas Medical Center Digestive Disease Center (DK56338), and the Dan L. Duncan Cancer Center. Dr White receives research support from the NIH (DK095082). The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs or the National Institutes of Health.