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  • Does knowledge of liver fibrosis affect high-risk drinking behaviour (KLIFAD)? protocol for a feasibility randomised controlled trial

    Jones, Katy A.; Rennick-Egglestone, Stefan (2021)
    INTRODUCTIONHeavy drinkers in contact with alcohol services do not routinely have access to testing to establish the severity of potential liver disease. Transient elastography by FibroScan can provide this information. A recent systematic review suggested providing feedback to patients based on markers of liver injury can be an effective way to reduce harmful alcohol intake. This randomised control trial (RCT) aims to establish the feasibility of conducting a larger national trial to test the effectiveness of FibroScan advice and Alcohol Recovery Video Stories (ARVS) in changing high-risk drinking behaviour in community alcohol services common to UK practice.METHODS AND ANALYSISThis feasibility trial consists of three work packages (WP). WP1: To draft a standardised script for FibroScan operators to deliver liver disease-specific advice to eligible participants having FibroScan. WP2: To create a video library of ARVS for use in the feasibility RCT (WP3). WP3: To test the feasibility of the trial design, including the FibroScan script and video stories developed in WP1 and WP2 in a one-to-one individual randomised trial in community alcohol services. Semi-structured interviews will be conducted at 6 months follow-up for qualitative evaluation. Outcomes will be measures of the feasibility of conducting a larger RCT. These outcomes will relate to: participant recruitment and follow-up, intervention delivery, including the use of the Knowledge of LIver Fibrosis Affects Drinking trial FibroScan scripts and videos, clinical outcomes, and the acceptability and experience of the intervention and trial-related procedures. Data analysis will primarily be descriptive to address the feasibility aims of the trial. All proposed analyses will be documented in a Statistical Analysis Plan.ETHICS AND DISSEMINATIONThis trial received favourable ethical approval from the West of Scotland Research Ethics Service (WoSRES) on 20 January 2021, REC reference: 20/WS/0179. Results will be submitted for publication to a peer-reviewed journal.TRIAL REGISTRATION NUMBERISRCTN16922410.
  • Mental health and hepatitis C

    Alvey, Richard; Holmes, Mark (2017)
    Richard Alvey, Cognitive Behavioural Therapist, and Mark Holmes, Head of Education, both at Institute of Mental Health, Nottinghamshire Healthcare NHS Trust, discuss addressing the mind–liver relationship in hepatitis services
  • Tears and laughter in the hall: Hearing the human story

    Holmes, Mark (2017)
    The article discusses the need to bring the voice of service users into nursing presentations in England.
  • Are strategies on alcohol-related liver disease just talk?

    Holmes, Mark (2016)
    The author reflects on progress on strategies on dealing with alcohol-related liver disease, as of June 2016. He recounts a local Public Health England liver event where he reflected on liver disease. He mentions reports about liver disease including "Measuring the Units: A Review of Patients Who Died With Alcohol-Related Liver Disease." He also cites the Alcohol Concern's Blue Light Project which highlights the interventions that can be made to work with change- resistant drinkers.
  • Dying for a drink: Alcohol across the lifespan

    Holmes, Mark (2013)
    We are a nation with an alcohol-induced dichotomy: we have a love affair with alcohol but are increasingly aware of its dangers. The pub has been a cornerstone of our society, providing a source of relationships and artistic imagination. However, our nation's favourite drug is also responsible for as many life-years lost as tobacco, but with additional psychological and socio-economic costs.
  • Technology-enabled care services: Novel method of managing liver disease

    Holmes, Mark (2014)
    Alcohol-related liver disease (ARLD) accounts for 37% of the patients who die from liver disease. Moreover, health professionals appear to have a pessimistic attitude toward these patients because ARLD is a self-inflicted illness and a lifestyle disease. This article examines a pilot study of follow-up services for patients with ARLD, particularly ascites, who are cared for by a team of alcohol-related long-term condition nurses. This simple telehealth approach required patients to take their weight readings and report their units of alcohol, texting them to a secure server for immediate automatic analysis and individual review. There were 12 participants in this service improvement study. This simple telehealth strategy was met with high levels of patient satisfaction, with a small cohort showing indications of feelings of control and support. This management approach should thus be considered for widespread implementation for clinical management of ascites and a further number of patients included to evaluate its effectiveness with a larger group.