Heptral® (Ademetionine) in Intrahepatic Cholestasis due to Chronic Non-Alcoholic Liver Disease: Subgroup Analysis of Results of a Multicentre Observational Study in India

Background: Rational drug prescribing can be defined as appropriate drugs prescribed in the right dose, at correct time intervals and for a sufficient duration. Alcoholic Liver Disease (ALD) and its complications are the principle cause for morbidity and mortality rate and accounts for elevated social and economic costs. The drug use will be a challenge for the physicians as there was no specific treatment for ALD, and decisions regarding treatment are critically depends on the symptoms and complications.Methods: A uni-centric prospective (observational) study was conducted for a period of 6months, to evaluate the current prescribing patterns used in treating ALD. All the patients admitted with diagnosis of ALD in General medicine department, both male and female medical wards were included in the study. General medicine outpatient department, special population such as pregnancy and psychiatry, patients below 18years and those who are not willing to sign in informed consent form was excluded from the study.Results: Number of males (98.02%) between age group 31-40years (29.6%) was more prone when compared to females (1.77%). Portal hypertension (30.35%) followed by jaundice (11.30%) and Ascites (10.71%) were frequently observed complications associated co-morbidities with ALD. WHO prescribing indicators showed deviation from there standard reference values. Diuretics (15.73%), antibiotics (13.14%), vitamin supplements (11.11%) and antacids (10.13%) categories were the most commonly prescribed for patients. The drugs prescribed from NLEM-2015 (82.11%) shows deviation from standard values.Conclusions: Futhermore, multi-centered studies should be conducted to draw best results on prescribing patterns of ALD in India.

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Psychosocial characteristics of alcoholic and non-alcoholic liver disease recipient candidates in liver transplantation: a prospective observational study

BMC Gastroenterology ◽

10.1186/s12876-021-02032-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Masato Shizuku ◽

Hiroyuki Kimura ◽

Hideya Kamei ◽

Shinichi Kishi ◽

Tatsuya Tokura ◽

...

Keyword(s):

Liver Transplantation ◽

Liver Disease ◽

Observational Study ◽

Alcoholic Liver Disease ◽

Prospective Observational Study ◽

Short Form ◽

Depression Scale ◽

Preoperative Period ◽

Psychosocial Characteristics ◽

Significant Difference

Abstract Background There are long-standing controversies about the transplant indications for alcoholic liver disease (ALD), because of the recognition that ALD is fundamentally self-inflicted. However, it is unclear whether psychosocial characteristics of ALD are different from that of non-alcoholic liver disease (NALD) in the selection of liver transplantation (LT) recipients. We aimed to clarify the psychosocial characteristics of ALD recipients (ALD-R)/ALD recipient candidates (ALD-RC) and NALD recipients (NALD-R)/ NALD recipient candidates (NALD-RC). Methods From 2011 to 2019, 75 patients were enrolled in this prospective observational study (ALD-RC, n = 19; NALD-RC, n = 56), LT were carried out as follow; ALD-R, n = 6; NALD-R, n = 52. We evaluated psychosocial characteristics in the preoperative period and 3, 12 months after LT (ALD-R, n = 3/3; NALD-R, n = 28/25). The following scales were used to evaluate psychosocial characteristics: Visual Analogue Scale, Alcohol Use Disorders Identification Test, Hospital Anxiety and Depression Scale, Beck Depression Inventory, Brief Evaluation of Medication Influences and Beliefs, Social Support Questionnaire (SSQ), Temperament and Character Inventory, Parental Bonding Instrument (PBI), the Short Form Health Survey (SF-36). Results When evaluating on the basis of abstinence rule, a comparison of ALD-RC and NALD-RC in the preoperative period identified similar patterns of psychosocial characteristics, except that the NALD-RC scored higher on the PBI item “overprotection from mother” (P < 0.05). The only significant difference between ALD-R and NALD-R after liver transplantation was in SSQ scores at 3 months. Conclusion The psychosocial characteristics of ALD-RC and NALD-RC may be similar when evaluated on the basis of Japan’s abstinence rule. This result also imply that the psychosocial characteristics of ALD-RC may differ from the previously reported psychosocial characteristics of alcohol dependent patients. These findings have the potential to provide helpful information for the evaluation of ALD-RC.

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