Hepatology-Led Education on Alcohol-Related Liver Disease During Chemical Dependency Treatment: Impact on Return to Drinking.

INTRODUCTION: Inpatient chemical dependency programs for alcohol use disorder (AUD) primarily focus on treating the use disorder, with limited attention to alcohol-related medical complications. We implemented a hepatology provider-led educational intervention focused on alcohol-related liver disease (ARLD) within an inpatient alcohol treatment program and evaluated the intervention's impact on return to alcohol use and subsequent healthcare utilization. METHODS: Data were collected between 1/2023 and 12/2024. Patients were categorized into historical and educational groups based on admission before or after implementation of the intervention. Data on return to alcohol use were collected through manual chart review. Demographics, ICD codes for AUD/ARLD, laboratory values, AUD medication use, return to alcohol and subsequent AUD/ARLD healthcare utilization, and mortality were also evaluated. Patients completed a voluntary survey asking for feedback regarding this intervention. Bivariate analyses assessed associations between patient characteristics and clinical outcomes. Kaplan-Meier methods estimated alcohol-free survival, and Cox proportional hazards regression estimated adjusted hazard ratios (HRs) for return to alcohol use. RESULTS: 465 patients (n=233 historical, n=232 educational) were included. Most patients were white (71.6%) males (65.4%) with a mean age of 40.2 ± 11.7 years. 38.9% of patients returned to alcohol use after treatment. The education intervention was associated with improved alcohol-free survival at one year (HR 0.67, 95%CI 0.50-0.93, p=0.016). Patients in the educational cohort had a higher frequency of healthcare encounters for compensated ARLD after treatment than those in the historical cohort (19.0% vs. 12.0%, p=0.041), primarily due to an increase in outpatient visits. Of those who completed surveys, 85.6% were interested in the topic, 83.1% believed it was helpful in maintaining sobriety, and 74.7% believed that they were more likely to follow-up with a provider to discuss their ARLD. CONCLUSION: Integrating a hepatology provider-led educational session into AUD treatment was associated with reduced return to drinking at one year. Individuals in the educational group may have been more empowered to seek medical evaluation and follow-up for liver disease after completing treatment. This intervention is scalable with potential to improve treatment of ALRD.