Changes in health-related quality of life in patients with alcohol-related liver disease after engaging in a sobriety in combination with journaling application (Preprint)

BACKGROUND Alcohol-related health problems are a major global issue, and the risks associated with continued harmful alcohol use affect patients' quality of life (QOL). Brief interventions using digital tools, such as smartphone apps, have shown potential in supporting abstinence and improving health outcomes. However, the effectiveness of such interventions on health-related QOL (HRQOL) in patients with alcohol-related liver disease (ALD) remains unclear. OBJECTIVE This study aims to assess changes in HRQOL over time in patients with ALD receiving outpatient care in conjunction with a smartphone journaling app study. METHODS A prospective study was conducted on 21 ALD outpatients from a gastroenterology and hepatology clinic who needed to abstinence from alcohol and who agreed to use a sobriety journaling app. HRQOL was assessed at the study entry, 8 weeks, and 24 weeks using the Japanese version of SF-36v2. RESULTS At 8 weeks, significant improvements were observed in the Physical Functioning (PF), Role Physical (RP), General Health (GH), and Role Emotional (RE) subscales. The Physical Component Summary (PCS) score significantly increased at 8 weeks. When HRQOL subscales or summary scores were tracked up to 24 weeks by dividing cases into the group that maintained abstinence for 8 weeks and the group that continued drinking, the abstinent group showed noticeable improvement in HRQOL over time. CONCLUSIONS In an app-based abstinence intervention in an outpatient liver clinic, achievement of abstinence was associated with improved physical HRQOL scores. However, no significant improvements were observed in mental and social aspects of HRQOL. This suggests that hepatologist-led interventions focusing on abstinence can effectively enhance the physical well-being of ALD patients, although additional psychiatric support may be necessary to address mental and social dimensions of HRQOL.