Gerald S Winder1,2,3, Anne C Fernandez1, Jessica L Mellinger4. 1. Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA. 2. Department of Surgery, University of Michigan, Ann Arbor, MI, USA. 3. Department of Neurology, University of Michigan, Ann Arbor, MI, USA. 4. Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
Abstract
Background/Aims: Alcohol-related liver disease (ALD) is the medical manifestation of alcohol use disorder, a prevalent psychiatric condition. Acute and chronic manifestations of ALD have risen in recent years especially in young people and ALD is now a leading indication of liver transplantation (LT) worldwide. Such alarming trends raise urgent and unanswered questions about how medical and psychiatric care can be sustainably integrated to better manage ALD patients before and after LT. Methods: Critical evaluation of the interprofessional implications of broad and multifaceted ALD pathophysiology, general principles of and barriers to interprofessional teamwork and care integration, and measures that clinicians and institutions can implement for improved and integrated ALD care. Results: The breadth of ALD pathophysiology, and its numerous medical and psychiatric comorbidities, ensures that no single medical or psychiatric discipline is adequately trained and equipped to manage the disease alone. Conclusions: Early models of feasible ALD care integration have emerged in recent years but much more work is needed to develop and study them. The future of ALD care is an integrated approach led jointly by interprofessional medical and psychiatric clinicians.
Background/Aims: Alcohol-related liver disease (ALD) is the medical manifestation of alcohol use disorder, a prevalent psychiatric condition. Acute and chronic manifestations of ALD have risen in recent years especially in young people and ALD is now a leading indication of liver transplantation (LT) worldwide. Such alarming trends raise urgent and unanswered questions about how medical and psychiatric care can be sustainably integrated to better manage ALD patients before and after LT. Methods: Critical evaluation of the interprofessional implications of broad and multifaceted ALD pathophysiology, general principles of and barriers to interprofessional teamwork and care integration, and measures that clinicians and institutions can implement for improved and integrated ALD care. Results: The breadth of ALD pathophysiology, and its numerous medical and psychiatric comorbidities, ensures that no single medical or psychiatric discipline is adequately trained and equipped to manage the disease alone. Conclusions: Early models of feasible ALD care integration have emerged in recent years but much more work is needed to develop and study them. The future of ALD care is an integrated approach led jointly by interprofessional medical and psychiatric clinicians.
Authors: Giovanni Addolorato; Antonio Mirijello; Lorenzo Leggio; Anna Ferrulli; Cristina D'Angelo; Gabriele Vassallo; Anthony Cossari; Giovanni Gasbarrini; Raffaele Landolfi; Salvatore Agnes; Antonio Gasbarrini Journal: Alcohol Clin Exp Res Date: 2013-04-11 Impact factor: 3.455
Authors: Sumeet K Asrani; James Trotter; Jack Lake; Aijaz Ahmed; Anthony Bonagura; Andrew Cameron; Andrea DiMartini; Stevan Gonzalez; Gene Im; Paul Martin; Philippe Mathurin; Jessica Mellinger; John P Rice; Vijay H Shah; Norah Terrault; Anji Wall; Scott Winder; Goran Klintmalm Journal: Liver Transpl Date: 2020-01 Impact factor: 5.799