Introduction A significant synergy exists between heavy alcohol consumption and hepatitis virus infection (hepatitis B and C), which may suggest a common pathway for hepatocarcinogenesis. Psychological interventions such as motivational interviewing (MI) can generate urgently needed psychological, physiological and lifestyle changes to people who use alcohol. No randomised controlled trials (RCTs) were found investigating effectiveness of MI in patients with chronic viral hepatitis and who drink alcohol.
Methods Using a RCT, patients were randomised into intervention and control groups. The Nurse Practitioner, Hepatology trained in MI provided the intervention. Demographic, clinical and patient-report data using AUDIT-C, Timeline Followback Survey_Alcohol (TLFB_A), World Health Organization Quality of Life _Brief (WHOQOL-Bref) were collected.
Results At 8 weeks, a reduction was found in both groups with 53% of the intervention group reporting a 50% reduction compared to 43% in the control (x2 = 0.382, p = 0.536). TLFB_A results were also found to significantly reduce over time (p < 0.001). Participants reported on average 14.1 (7.7, 25.4; P < 0.001) drinks after 8 weeks. The intervention group reported 18.8 (10.9, 32.2) drinks and generally reported a lower mean TLFB_A compared to the control group 32.4 (18.7, 55.7; p = 0.1.66). A clear trend emerged with the intervention group showing a much sharper sustained drop in TLFB_A results over time. The results of the AUDIT C were found to reduce over time (p = 0.001). Mean AUDIT C results were significantly lower at 8 weeks 5.4 (4.5, 6.3; p = 0.001) compared to baseline 6.9 (6.2, 7.6). It was found the intervention group tended to have a slightly higher reduction of alcohol consumption over time.
Conclusion Motivational Interviewing proved an acceptable intervention for the nurse practitioner and this cohort of patients. A number of implications for practice were identified including improvements to patient clinical assessment practices and the provision of a MI intervention for alcohol reduction.
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