Integrated Treatment of Persons with Co-Occurring HCV and Alcohol Use/Abuse

对同时患有丙型肝炎和酗酒/酗酒者的综合治疗

• 批准号: 7687970
• 负责人: Andrew J. Muir
• 金额: $ 18.53万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-15 至 2011-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7687970
• 关键词: Address; Adherence; Adoption; Adult; Affect; African American; Alcohol abuse; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Antiviral Agents; Appointment; Area; Attention; Behavioral; Blood; Caring; Cessation of life; Clinic; Clinical Trials Design; Consumption; Data; Disease; Effectiveness; Eligibility Determination; Foundations; Grant; HIV; Health; Health Personnel; Hepatitis C; Hepatitis C virus; Human immunodeficiency virus test; Individual; Intervention; Lead; Lesion; Liver; Liver Failure; Liver Fibrosis; Location; Medical; Mental Health; Mental disorders; Modeling; Outcome; Participant; Patient Participation; Patients; Persons; Pharmacological Treatment; Population; Populations at Risk; Primary carcinoma of the liver cells; Protocols documentation; Provider; Randomized Controlled Trials; Readiness; Research; Research Design; Risk; Sample Size; Sampling; Services; Substance abuse problem; Testing; Time; United States; Virus; addiction; alcohol abuse therapy; behavior change; behavioral health; contextual factors; design; drinking; effective therapy; improved; liver transplantation; medical specialties; open label; patient population; post intervention; primary care setting; problem drinker; standard of care; therapy design; treatment planning; trend; trial comparing

DESCRIPTION (provided by applicant): BACKGROUND: For those infected with hepatitis C (HCV), alcohol use has a direct negative impact on the liver, increasing the risk and progression of liver fibrosis and hepatocellular carcinoma, which can lead to liver failure and death. Few studies have systematically examined effective approaches to address co-occurring HCV and alcohol use. Integrated Behavioral Health-Medical models have demonstrated decreases in alcohol use in primary care settings, but have rarely been tested in HCV specialty care settings. Data on integrated models for African American patients with HCV are lacking. Medical providers need data on effective treatments for the spectrum of problem drinking with which their HCV-infected patients present. AIMS: The objective of this R21 is to test the feasibility of implementing a promising integrated treatment model tested among persons with HIV and problem drinking to persons with HCV and problem drinking ranging from hazardous consumption to harmful alcohol use. This R21 proposal will examine a) the feasibility of adapting an integrated intervention designed for alcohol-using HIV populations to an HCV population; b) the impact of this intervention on participation in alcohol treatment, changes in alcohol use, and participation in HCV medical care; and c) the factors associated with outcomes in this sample. RESEARCH DESIGN: Sixty participants will receive the Integrated Alcohol-HCV treatment model provided at an HCV medical clinic. Outcome variables will be assessed pre-, during, and post-intervention. If successfully implemented with positive outcome trends, the results from this study will be used to prepare an R01 proposal that will employ a Randomized Controlled Trial (RCT) design to test the integrated model's effectiveness. SIGNIFICANCE: Results from this study will serve as the foundation for a full-scale RCT to test the effectiveness of an integrated service model with HCV patient populations. There are a number of important areas which this research is designed to address. First, this study will examine the utility of an integrated approach to enhance participation in alcohol treatment for persons with co-occurring HCV and a range of problem drinking. Second, the results could help define principles for integrating care across a number of similar disease states. Finally, this study may lead to greatly enhanced understanding of the contextual factors that impact on patient participation as well as other critical outcomes in this at-risk population.

描述（由申请人提供）：背景：对于感染丙型肝炎（HCV）的人来说，饮酒会对肝脏产生直接的负面影响，增加肝纤维化和肝细胞癌的风险和进展，从而导致肝衰竭和死亡。很少有研究系统地研究解决丙型肝炎和饮酒同时发生的有效方法。综合行为健康-医疗模型已证明初级保健机构中酒精使用量的减少，但很少在丙型肝炎专科护理机构中进行测试。缺乏非裔美国 HCV 患者综合模型的数据。医疗服务提供者需要针对 HCV 感染患者存在的一系列饮酒问题的有效治疗方法的数据。目的：R21 的目的是测试实施一种有前途的综合治疗模式的可行性，该模式在艾滋病毒感染者和饮酒问题患者中进行测试，在丙型肝炎病毒感染者和饮酒问题患者中进行测试，范围从危险消费到有害酒精使用。该 R21 提案将审查 a) 将针对饮酒 HIV 人群设计的综合干预措施应用于 HCV 人群的可行性； b) 该干预措施对参与酒精治疗、饮酒变化和参与丙肝病毒医疗护理的影响； c) 与该样本结果相关的因素。研究设计：60 名参与者将接受 HCV 医疗诊所提供的酒精-HCV 综合治疗模式。结果变量将在干预前、干预期间和干预后进行评估。如果成功实施并取得积极的结果趋势，这项研究的结果将用于准备 R01 提案，该提案将采用随机对照试验 (RCT) 设计来测试集成模型的有效性。意义：本研究的结果将作为全面随机对照试验的基础，以测试针对 HCV 患者群体的综合服务模式的有效性。这项研究旨在解决许多重要领域。首先，本研究将探讨综合方法的效用，以提高同时患有丙型肝炎和一系列饮酒问题的患者参与酒精治疗的程度。其次，研究结果可以帮助定义在许多类似疾病状态下整合护理的原则。最后，这项研究可能会大大加深对影响患者参与的背景因素以及该高危人群的其他关键结果的理解。