Michigan Alcohol Improvement Network- Alcohol Reduction and Treatment Trial

Study Overview
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Brief Summary
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The purpose of the study is to determine if providing participants with alcohol-related liver disease with tailored alcohol use treatment options is feasible and acceptable in order to increase their engagement with treatment and reduce alcohol use. This is an important area to study to help create ways to increase participants' knowledge about different treatment options as well as increase likelihood of seeking and participating in alcohol use disorder treatments.

Official Title
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Michigan Alcohol Improvement Network- Alcohol Reduction and Treatment Trial

Conditions
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Alcohol-Related Disorders, Liver Diseases

Intervention / Treatment
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* Behavioral: Michigan Alcohol Improvement Network-Alcohol Reduction and Treatment tool


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Enrolled at University of Michigan general hepatology clinics or inpatient wards Documented diagnosis of alcohol-associated cirrhosis or alcoholic hepatitis or alcohol-related liver disease of any stage Drinking of any amount of alcohol within the 6 months prior to recruitment No alcohol use treatment within the past 1 month Access to a phone for purposes of follow-up Exclusion Criteria: Active alcohol use treatment Undergoing active evaluation for liver transplantation, is listed for liver transplant, or is post-transplantation. Is enrolled in the multidisciplinary alcohol-related liver disease clinic at Michigan Medicine

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: MAIN-ART Behavior Tool<br>The Michigan Alcohol Improvement Network- Alcohol Reduction and Treatment Tool (MAIN-ART) behavioral intervention is an online web application with two modules: misconception correction and tailored, preference-sensitive alcohol use disorder (AUD) treatment matching. | Behavioral: Michigan Alcohol Improvement Network-Alcohol Reduction and Treatment tool<br>* The intervention corrects misconceptions about alcohol use, liver disease, and alcohol treatment and matches patients to their top three choices of treatment while providing them with brief explanations of each treatment option.<br>|
| No Intervention: Routine care<br>Patients randomized to usual care will receive a pamphlet for alcohol treatment referral to the University of Michigan Addiction Treatment Services, but will receive no further education from the research team. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Feasibility of MAIN-ART Tool as Measured by Recruitment Rates | Feasibility of administration of the MAIN-ART tool will be determined by recruitment rates and retention rates (as measured at 6 months after recruitment). Study recruitment started on 23 September, 2020 and concluded on 10 January 2022. The results reflect the number and percent of those patients who were approached, were determined to be eligible, and were consented. | Up to 6 months | 
| Feasibility of MAIN-ART Tool as Measured by Retention Rates | Feasibility of administration of the MAIN-ART tool will be determined by recruitment rates and retention rates (as measured at 6 months after recruitment). Retention rate is shown by the number of participants who continued in the study for 6 months, and the percentage that it represents compared to those who began it but did not follow through to the end of the study (6 months). | Up to 6 months | 
| Acceptability of the MAIN-ART Tool as Measured by Post-intervention Surveys | On the day the participants engage with the MAIN-ART tool, acceptability will be determined by patient-level surveys. The System usability Survey (SUS) consists of 10 questions ranging from 1 (strongly disagree) to 5 (strongly agree). A scoring algorithm which produces a range from 0 to 100 was used. Current literature suggests that a score above 68 for mean SUS is considered above average. By intervention, this measure means interaction with the MAIN-ART tool, which occurs only at the participant's initial visit. | Up to 1 hour | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Alcohol Use Frequency as Measured by the Alcohol Timeline Follow-back (TLFB) Interview | Alcohol use will be defined according to World Health Organization (WHO) risk drinking level. WHO drinking risk levels were derived from patient reports of the number of standard drinks (defined as 0.6 ounces of absolute alcohol) consumed, which were converted to grams of pure alcohol (0.6 ounces = 14 grams). Ranging from abstinence (0 grams) to very high risk (101+ males / 61+ females grams). | Baseline and 6 months | 
| Alcohol Treatment Engagement as Measured by Number of Participants Who Engaged in Any Alcohol Cessation or Reduction Visit as Measured by Self-report. | Alcohol treatment engagement will be defined as at least one visit with formal, external assistance in alcohol cessation or reduction including inpatient rehabilitation services, out patient alcohol cessation programs, engagement in therapy of any kind tailored for alcohol cessation, and engagement in any group therapy or support groups for alcohol cessation including alcoholics anonymous, 12 step facilitation and etc. | Up to 6 months |