{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T04:24:00Z","timestamp":1777350240556,"version":"3.51.4"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,3,28]],"date-time":"2022-03-28T00:00:00Z","timestamp":1648425600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006379","name":"Office of Research and Development","doi-asserted-by":"publisher","award":["2I0CX001076"],"award-info":[{"award-number":["2I0CX001076"]}],"id":[{"id":"10.13039\/100006379","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007181","name":"Quality Enhancement Research Initiative","doi-asserted-by":"publisher","award":["PEC 19\u2010307"],"award-info":[{"award-number":["PEC 19\u2010307"]}],"id":[{"id":"10.13039\/100007181","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alcoholism Clin &amp;amp; Exp Res"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Untreated alcohol use disorder (AUD) is associated with poor cirrhosis outcomes. We evaluated factors associated with AUD treatment discussions and initiation in the Veterans Health Administration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Chart reviews were conducted for veterans with International Classification of Diseases codes for both cirrhosis and AUD who were receiving care at one of three large medical centers in 2020. Factors associated with a 1\u2010year offer of AUD treatment and its acceptance were assessed using regression models, which included as covariates demographic characteristics, comorbidities, and depression, as measured by the patient health questionnaire (PHQ\u20102) from the electronic health record.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The cohort included 654 veterans, 68 of whom were engaged in AUD treatment at baseline and 174 who were documented as being in AUD remission. Treatment was offered to 264 (64%) of the 412 veterans with opportunities to initiate it. AUD treatment discussions were most often documented by practitioners in primary care (<jats:italic>n<\/jats:italic>\u00a0=\u00a0162), hepatology (<jats:italic>n<\/jats:italic>\u00a0=\u00a045), or both (<jats:italic>n<\/jats:italic>\u00a0=\u00a041). Multivariable logistic regression modeling revealed that treatment was significantly more likely to be offered to patients with co\u2010occurring bipolar disorder (OR 2.94, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.03) or depression (1.50, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.05) or who were younger (0.97, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.01). Of the 264 patients offered AUD treatment, 107 (40%) agreed to initiate it. Acceptance of an offer of treatment was significantly associated with hospitalization in the prior year (OR 1.74, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.05), prior AUD treatment (9.92, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.0001), and a higher PHQ\u20102 depression score (2.85, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.004).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We identified factors associated with an offer of AUD treatment and its initiation among veterans with cirrhosis. Application of these findings could increase the likelihood that veterans with alcoholic cirrhosis initiate AUD treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acer.14809","type":"journal-article","created":{"date-parts":[[2022,3,21]],"date-time":"2022-03-21T06:54:50Z","timestamp":1647845690000},"page":"809-814","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Patient\u2010 and provider\u2010level factors that underlie alcohol use disorder treatment offer and acceptance in veterans with cirrhosis"],"prefix":"10.1111","volume":"46","author":[{"given":"Rahul B.","family":"Chaudhari","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition Virginia Commonwealth University and Richmond VA Medical Center  Richmond Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikki","family":"Duong","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition Virginia Commonwealth University and Richmond VA Medical Center  Richmond Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shreesh","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition Virginia Commonwealth University and Richmond VA Medical Center  Richmond Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bryan","family":"Badal","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition Virginia Commonwealth University and Richmond VA Medical Center  Richmond Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neerav","family":"Dharia","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition Virginia Commonwealth University and Richmond VA Medical Center  Richmond Virginia 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