{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T14:16:05Z","timestamp":1768832165295,"version":"3.49.0"},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T00:00:00Z","timestamp":1716249600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>To examine the healthcare contacts of patients in the year before an index admission to hospital with alcohol\u2010related liver disease (ArLD) to identify where opportunities for earlier identification of alcohol use disorders (AUD) and ArLD and intervention may occur.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study using the regional database encompassing NHS organisations across North West London (344 general practitioner [GP] practices, 4 acute hospital trusts and 2 mental health and community health trusts). Patients who had an index admission with ArLD were identified through healthcare coding and compared with a control cohort. Healthcare contacts, blood tests and AUD testing in the year preceding admission were measured.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The ArLD cohort had 1494 participants with an index hospital admission with ArLD. The control cohort included 4462 participants. In the year preceding an index admission with ArLD, 91% of participants had at least one contact with primary care with an average of 2.97 (SD 2.45) contacts; 80% (<jats:italic>n<\/jats:italic>\u2009=\u20091199\/1494) attended ED, 68% attended an outpatient clinic, and 42% (<jats:italic>n<\/jats:italic>\u2009=\u2009628\/1494) had at least one inpatient admission. Only 9% of the ArLD (137\/1494) had formal testing for AUD. Abnormal bilirubin and platelets were more common in the ArLD than the control cohort 25% (138\/560) and 28% (231\/837), respectively, v 1% (12\/1228) and 1% (20\/1784).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Prior to an index admission with ArLD patients have numerous interactions with all healthcare settings, indicating missed opportunities for early identification and treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.15969","type":"journal-article","created":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T09:48:45Z","timestamp":1716284925000},"page":"2273-2281","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Healthcare interactions prior to first hospital admission with alcohol\u2010related liver disease"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6358-9137","authenticated-orcid":false,"given":"Heather","family":"Lewis","sequence":"first","affiliation":[{"name":"Liver Unit Imperial College NHS Healthcare Trust, St Marys Hospital London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4888-8670","authenticated-orcid":false,"given":"Richard","family":"Parker","sequence":"additional","affiliation":[{"name":"Leeds Liver Unit St James's University Hospital  Leeds UK"},{"name":"Discover\u2010NOW Imperial College Health Partners  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zia","family":"Ul\u2010Haq","sequence":"additional","affiliation":[{"name":"Discover\u2010NOW Imperial College Health Partners  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda","family":"Lucas","sequence":"additional","affiliation":[{"name":"Discover\u2010NOW Imperial College Health Partners  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carole","family":"Cohen","sequence":"additional","affiliation":[{"name":"Discover\u2010NOW Imperial College Health Partners  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikhil","family":"Vergis","sequence":"additional","affiliation":[{"name":"Digestive Diseases Division, Department of Metabolism, Digestion and Reproduction Imperial College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Thursz","sequence":"additional","affiliation":[{"name":"Digestive Diseases Division, Department of Metabolism, Digestion and Reproduction Imperial College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,5,21]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Public Health England.Liver disease profiles: short statistical commentary.2018."},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(19)30349-8"},{"key":"e_1_2_11_4_1","first-page":"209","article-title":"The epidemiology of alcoholic liver disease","volume":"27","author":"Mann RE","year":"2003","journal-title":"Alcohol Res Health"},{"key":"e_1_2_11_5_1","unstructured":"BrownL.Health survey for England 2015: adult alcohol consumption.2016. 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