Impact of Knowledge of liver fibrosis on drinking behaviour
Research type
Research Study
Full title
Does knowledge of liver fibrosis affect high-risk drinking behaviour (KLIFAD): Feasibility randomised controlled trial
IRAS ID
273765
Contact name
Mohsan Subhani
Contact email
Sponsor organisation
Nottinghamshire Healthcare NHS Foundation Trust
Duration of Study in the UK
1 years, 11 months, 30 days
Research summary
Summary of Research
Heavy drinkers at risk of liver disease and in contact with alcohol services do not currently have access to testing to establish the severity of their liver disease. Fibroscan is a technology which can now provide this information. It is currently unknown if knowledge of the severity of liver disease in people who are at risk will affect their drinking behaviour. This study sets out to develop standardised fibroscan operator feedback of results and produce video patient stories to enhance feedback and then establish if the approach is feasible and deliverable via a feasibility randomised controlled trial.
The feasibility RCT will be conducted at three community-based alcohol settings hosted by Framework and Nottingham recovery Network and work in partnership with Nottinghamshire NHS foundation trust
• Wellbeing Hub
• Edwin House
• Primary care alcohol clinic run by Nottingham Recovery Network (NRN)
The trial has three work packages (WP),
1. WP1: To establish a standardised script framework
The patient participant will be involved in the focus group to provide feedback on the prototype fibroscan script and Change model questionnaire. The NRN alcohol keyworker in a focus group will give feedback on the final version.
2. WP2: To develop and film video stories using eligible participants
We will record the videos of alcohol recovery stories from participants who have successfully overcome their alcohol use disorder and had fibroscan in past.
3. WP3: As per study protocol test the feasibility randomised control trial design
The Wellbeing Hub and primary care clinic (NHS lead) run 12-week treatment programmes initiated after an initial assessment. The study site staff and/or study team will give patient information to eligible candidates at the initial visit. The baseline visit will be when participant return to start the programme. The next visit will be at 3 months which will be part of routine care. At 6-month participant will be contacted via telephone, or if feasible and participant prefer in-person appointment will be arranged following government COVID guidelines. The participant in the control group will also be offered a fibroscan.Summary of Results
Background Liver disease caused by alcohol consumption is a major health concern in the UK. Often, people do not realise they have liver damage until it is too late for effective treatment. Early detection could encourage individuals to reduce their alcohol intake, potentially preventing serious health problems. This study, called KLIFAD, aimed to see if testing liver stiffness using a simple, non-invasive scan (transient elastography) and providing personal feedback on liver health could help people change their drinking habits. The study also explored whether watching video stories from people who had successfully reduced or stopped drinking (Alcohol Recovery Video Stories, or ARVS) would support behaviour change.Study Aims
The main goal was to determine whether it would be possible to run a larger study to test these approaches in community alcohol services. The researchers wanted to know whether people would take part, whether they would complete the study, and whether the intervention might help reduce harmful drinking.What We Did
The study involved 128 adults who were receiving support for alcohol problems at three different community alcohol services in the East Midlands. Participants were randomly assigned to one of two groups:A control group that received usual alcohol treatment.
An intervention group that received usual treatment plus a liver scan and personalised feedback, with access to recovery video stories.
Researchers measured how many people stayed engaged with alcohol support services and whether they reduced their drinking after six months.
Key Findings
The study was feasible: 77% of eligible people agreed to take part, and 68% completed follow-up.
One in five people who had a liver scan showed signs of significant liver damage.
People in the intervention group were more likely to complete their alcohol treatment programme (54.9% vs. 43.9%).
The intervention group had a slightly longer engagement with services (average 8.6 days longer than the control group).
More people in the intervention group reduced their alcohol intake to a level where they were no longer classed as alcohol-dependent (41.5% vs. 20.6%).
Watching recovery video stories was less popular than expected, with only 25% of participants using this resource.
There were no negative effects from telling participants their liver scan results, and no one in the intervention group increased their alcohol intake because of the findings.
Why This Matters
The results suggest that using liver scans in community alcohol services is practical and may help people reduce their drinking. The study highlights a significant number of people with undiagnosed liver disease, supporting the need for earlier detection. The personalised feedback based on liver health appears to motivate behaviour change.Next Steps
A larger study is needed to confirm these findings and explore ways to improve engagement with recovery video stories. Future research could also investigate how to better support people with both alcohol problems and mental health conditions, as these individuals were more likely to struggle with completing treatment.Conclusion
Using liver scans and personalised feedback in alcohol support services is a promising approach to encourage people to reduce their alcohol intake and engage more with treatment. This could lead to earlier detection of liver disease and better long-term health outcomes.
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REC name
West of Scotland REC 5
REC reference
20/WS/0179
Date of REC Opinion
20 Jan 2021
REC opinion
Further Information Favourable Opinion