Confronting the Crisis of Comorbid Alcohol Use Disorder and Alcohol-Related Liver Disease With a Novel Multidisciplinary Clinic

Alcohol-related liver disease (ALD) is prevalent and deadly and increasingly affects younger people and women. No single discipline is adequately equipped to manage its biopsychosocial complexity. Depict the scope of the ALD problem, provide a narrative review of other integrated care models, share...

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Bibliographic Details
Published in:Psychosomatics (Washington, D.C.) D.C.), 2020-05, Vol.61 (3), p.238-253
Main Authors: Winder, Gerald Scott, Fernandez, Anne C., Klevering, Kristin, Mellinger, Jessica L.
Format: Article
Language:English
Subjects:
Adult
alcohol use disorder
alcohol-related liver disease
Alcoholism - therapy
Ambulatory Care Facilities
cirrhosis
Delivery of Health Care, Integrated - methods
Disease Management
Female
hepatitis
Humans
liver
Liver Diseases, Alcoholic - therapy
Liver Transplantation
Male
Middle Aged
multidisciplinary
Referral and Consultation
United States
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Summary:Alcohol-related liver disease (ALD) is prevalent and deadly and increasingly affects younger people and women. No single discipline is adequately equipped to manage its biopsychosocial complexity. Depict the scope of the ALD problem, provide a narrative review of other integrated care models, share our experience forming and maintaining a multidisciplinary ALD clinic for over a year, and provide recommendations for replication elsewhere. Critical evaluation of clinic implementation and its first year of operation. The clinical rationale for multidisciplinary ALD treatment is clear and supported by the literature. Such models are feasible although surprisingly rare and vulnerable to various surmountable challenges. Successful ALD clinics must be built by teams with solid personal and professional relationships, supported by institutional leadership, and must use a new kind of multidisciplinary paradigm and training. Consultation-liaison psychiatry is uniquely positioned to lead future efforts in the care and study of ALD.
ISSN:0033-3182
1545-7206
DOI:10.1016/j.psym.2019.12.004