Project 2-Optimization of Post-Transplant care via Biomarkers and Behavioral Interventions
项目 2 - 通过生物标志物和行为干预优化移植后护理
基本信息
- 批准号:10560559
- 负责人:
- 金额:$ 40.68万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2019
- 资助国家:美国
- 起止时间:2019-02-01 至 2025-01-31
- 项目状态:未结题
- 来源:
- 关键词:Alcohol consumptionAlcoholic HepatitisAlcoholic Liver DiseasesAlcoholsAllograftingAnxietyAttentionBehavior TherapyBiological MarkersCaringCessation of lifeClinicClinicalCognitive TherapyComputersConsumptionCounselingDataDiseaseDisease ProgressionDrug usageEarly InterventionEthanolEvidence based treatmentFailureFamilyHeavy DrinkingHomeHospitalsInjectableInstructionInternetInterventionLiver diseasesMeasuresMedicalMonitorMoodsNaltrexoneNursesOnline SystemsOralOutcomeOutcome MeasureOutpatientsPatient PreferencesPatient Self-ReportPatient-Focused OutcomesPatientsPersonsPharmacotherapyPhysiciansProviderPsychiatric therapeutic procedureQuality of lifeRandomizedRecording of previous eventsRelapseReportingResourcesScheduleServicesSocial supportSpeedTestingTextTransplant RecipientsTransplantationUnited StatesVisitalcohol abstinencealcohol abuse therapyalcohol consequencesalcohol cravingalcohol effectalcohol interventionalcohol measurementalcohol monitoringalcohol relapsealcohol servicesalcohol use disorderbiomarker validationbrief alcohol interventiondrinkingexperiencefollow-uphigh riskhigh risk populationimplementation studyimprovedindividualized medicineinstrumentinterdisciplinary approachliver transplantationmortalitypost-transplantprospectivepsychiatric symptomreduced alcohol userelapse patientsspecific biomarkerstailored text messagingtau Proteinstransplantation therapytreatment adherencetreatment as usualtreatment services
项目摘要
In the United States, alcoholic liver disease (ALD) is the second most common indication for liver
transplant (LT). Traditionally, ALD patients have been required to complete a six-month mandatory period of
alcohol abstinence before LT. More recently early LT for severe alcoholic hepatitis is being performed without
any pre-transplant alcohol treatment because of the high medical acuity and mortality associated with this
disease. Importantly, the limited studies to-date demonstrate comparable survival among early (ELT) versus
standard (SLT) transplant recipients. Return to alcohol use is a major concern for all LT recipients with ALD,
with estimates of alcohol relapse ranging between 16 and 49%. Although most LT clinics have enforced pre-LT
alcohol treatment, far less attention has been paid to post-LT services, despite the high risk and severe
consequences of relapse during this period. Numerous evidence-based treatments are available for alcohol
use disorder (AUD). In recent years, our group and others have developed web- and text-based versions of
these empirically-supported interventions to expand their reach and replicability outside of formal alcohol clinic
settings. Delivery of AUD interventions in non-traditional settings is feasible, acceptable to patients, and
effective in reducing alcohol use. We propose to implement and evaluate the effects of alcohol treatment
integrated into routine post-LT care. All patients receive physician instructions to stop drinking and engage in
alcohol services (treatment as usual: TAU). ELT (N=100) and SLT (N=100) patients will be randomized on a
2:1 basis to integrated AUD treatment (IAT) or TAU. IAT will include computer-delivered BI in the hospital,
nurse-delivered alcohol monitoring counseling at each outpatient LT follow-up visit, and at-home participation
in web-based, 7-session CBT4CBT, supplemented by tailored text messages. Also, because of the evidence
that ALD patients significantly underreport their drinking to LT providers, we will compare post-LT alcohol
relapse rates using a well-validated biomarker of recent drinking (PEth), patient self-report on a validated
alcohol instrument, and patient report to their LT provider. Finally, we will identify predictors of post-LT alcohol
use and treatment engagement for ELT and SLT patients. Key measures will include: alcohol use;
engagement in alcohol treatment; retention in post-transplant follow-up care; mood and anxiety; and quality of
life. Given the severe consequences of alcohol relapse among both ELT and SLT recipients, it is critical to
accurately identify alcohol use and implement alcohol interventions early in the post-transplant period to
optimize short- and long-term patient outcomes and ultimately tailor treatments for this high-risk population.
在美国,酒精性肝病(ALD)是第二个最常见的肝脏适应症
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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{{ truncateString('MARY E MCCAUL', 18)}}的其他基金
Project 2-Optimization of Post-Transplant care via Biomarkers and Behavioral Interventions
项目 2 - 通过生物标志物和行为干预优化移植后护理
- 批准号:
10356014 - 财政年份:2019
- 资助金额:
$ 40.68万 - 项目类别:
Project 2-Optimization of Post-Transplant care via Biomarkers and Behavioral Interventions
项目 2 - 通过生物标志物和行为干预优化移植后护理
- 批准号:
10093987 - 财政年份:2019
- 资助金额:
$ 40.68万 - 项目类别:
Combined mGluR5 PET and fMRI imaging of Sex Differences during Cocaine Withdrawal
可卡因戒断期间性别差异的 mGluR5 PET 和 fMRI 联合成像
- 批准号:
9897512 - 财政年份:2017
- 资助金额:
$ 40.68万 - 项目类别:
Combined mGluR5 PET and fMRI imaging of Sex Differences during Cocaine Withdrawal
可卡因戒断期间性别差异的 mGluR5 PET 和 fMRI 联合成像
- 批准号:
9331813 - 财政年份:2017
- 资助金额:
$ 40.68万 - 项目类别:
Alcohol and Comorbid Tobacco Use Disorders: PET Imaging of Glutamate System Effects
酒精和烟草使用障碍:谷氨酸系统影响的 PET 成像
- 批准号:
9285689 - 财政年份:2015
- 资助金额:
$ 40.68万 - 项目类别:
HOMOCYSTEINE, A CANDIDATE PERIPHERAL BIOMARKER FOR CEREBRAL mGluR5 ACTIVITY IN COMORBID ALCOHOL- AND TOBACCO USE DISORDER
同型半胱氨酸,酒精和烟草使用障碍中大脑 mGluR5 活性的候选外周生物标志物
- 批准号:
9479534 - 财政年份:2015
- 资助金额:
$ 40.68万 - 项目类别:
Stress Effects on Alcohol Consumption: Age of onset and genes in heavy drinkers
压力对饮酒的影响:酗酒者的发病年龄和基因
- 批准号:
8606722 - 财政年份:2012
- 资助金额:
$ 40.68万 - 项目类别:
8/8: INIA Stress and Chronic Alcohol Interactions: Glucocorticoid antagonists in heavy drinkers:effects on fMRI connectivity, withdrawal and drinking
8/8:INIA 压力和慢性酒精相互作用:重度饮酒者中的糖皮质激素拮抗剂:对功能磁共振成像连接、戒断和饮酒的影响
- 批准号:
9242249 - 财政年份:2012
- 资助金额:
$ 40.68万 - 项目类别:
Stress Effects on Alcohol Consumption: Age of onset and genes in heavy drinkers
压力对饮酒的影响:酗酒者的发病年龄和基因
- 批准号:
8425097 - 财政年份:2012
- 资助金额:
$ 40.68万 - 项目类别:
Stress Effects on Alcohol Consumption: Age of onset and genes in heavy drinkers
压力对饮酒的影响:酗酒者的发病年龄和基因
- 批准号:
8230145 - 财政年份:2012
- 资助金额:
$ 40.68万 - 项目类别:
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