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Significant Intervention Opportunities Missed in Alcohol-Related Liver Disease Deaths
Among a cohort of people who died of alcohol-related liver disease (ARLD), half were never diagnosed with ARLD, or received a diagnosis less than 6 months before death, despite dozens of healthcare interactions, according to new study findings published online in Drug and Alcohol Review.
“The message that health improvement is the responsibility of all healthcare professionals is not yet fully embedded, despite assurances to the contrary,” wrote researchers from the University of Nottingham School of Medicine in the United Kingdom.
The study focused on 799 adults who died of ARLD between 2012 and 2017 in Nottinghamshire, England. Researchers retrospectively analyzed data from the Office for National Statistics and Hospital Episode Statistics databases to test associations between key variables and ARLD mortality.
According to the study, 13% of those who died of ARLD had never been diagnosed with the disease, and a further 37.4% had a first ARLD diagnosis just 6 months or less before death. Emergency presentation at first ARLD diagnosis and white ethnicity were significantly linked with delayed diagnosis.
Overall, people in the cohort had a median 25 interactions with the local health care system in the 5 years before their death: 5 hospital admissions, 4 accident and emergency attendances, and 16 outpatient appointments, data showed. Treatment was most commonly provided by general medicine, although a range of specialties were also involved.
Most admissions, the authors pointed out, were linked with alcohol.
“These individuals are frequent healthcare attendees, and there are numerous opportunities to identify alcohol misuse and intervene,” researchers wrote. “However, these opportunities are not being maximized.”
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