Gerald Scott Winder1, Anne C Fernandez2, Kristin Klevering2, Jessica L Mellinger3. 1. Department of Psychiatry, University of Michigan, Ann Arbor, MI; Department of Surgery, University of Michigan, Ann Arbor, MI. Electronic address: gwinder@med.umich.edu. 2. Department of Psychiatry, University of Michigan, Ann Arbor, MI. 3. Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI.
Abstract
BACKGROUND: 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. OBJECTIVES: 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. METHODS: Critical evaluation of clinic implementation and its first year of operation. RESULTS: 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. CONCLUSIONS: 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.
BACKGROUND: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. OBJECTIVES: 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. METHODS: Critical evaluation of clinic implementation and its first year of operation. RESULTS: 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. CONCLUSIONS: 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.
Authors: Ashwani K Singal; Paul Kwo; Allison Kwong; Suthat Liangpunsakul; Alexandre Louvet; Pranoti Mandrekar; Craig McClain; Jessica Mellinger; Gyongyi Szabo; Norah Terrault; Mark Thursz; Gerald S Winder; W Ray Kim; Vijay H Shah Journal: Hepatology Date: 2021-11-27 Impact factor: 17.298
Authors: Jessica L Mellinger; Gerald Scott Winder; Anne C Fernandez; Kristin Klevering; Amanda Johnson; Haila Asefah; Mary Figueroa; Jack Buchanan; Fred Blow; Anna S F Lok Journal: J Subst Abuse Treat Date: 2021-04-09
Authors: Juan Pablo Arab; Manhal Izzy; Lorenzo Leggio; Ramon Bataller; Vijay H Shah Journal: Nat Rev Gastroenterol Hepatol Date: 2021-11-01 Impact factor: 73.082
Authors: Clair Le Boutillier; Claire Snowdon; Vishal Patel; Mark McPhail; Christopher Ward; Ben Carter; Ruhama Uddin; Ane Zamalloa; Vanessa Lawrence Journal: PLoS One Date: 2022-02-03 Impact factor: 3.240