What type of study is this?

This is a Systematic Review study (also classified as: Meta-Analysis).

September 23, 2025

Psychosocial therapy improves outcomes for alcohol use disorder in people with chronic liver disease: A systematic review and meta-analysis.

CSC. SollenbergerCalifornia University of Pennsylvania HCHuai-En R ChangNational Institute of Diabetes and Digestive and Kidney Diseases JLJonathan LimProvidence College

Puntos clave

Psychosocial therapy significantly reduces return-to-drinking risk in patients with chronic liver disease and alcohol use disorder.
The meta-analysis revealed a 48% reduction in return-to-drinking risk among those receiving psychosocial interventions.
Twenty studies were reviewed; the meta-analysis included seven non-randomized controlled trials with a total of 767 participants.
Findings highlight the importance of multidisciplinary care in managing alcohol use disorder among liver transplant recipients.

Resumen

Psychosocial interventions are effective for alcohol use disorder (AUD), but their impact on patients with chronic liver disease and AUD remains unclear. This systematic review and meta-analysis evaluated the effectiveness of psychosocial therapies in preventing return-to-drinking and promoting abstinence among this population. The protocol (CRD42024527757) was registered in Prospero. We included studies involving adults (≥18 y) with chronic liver disease and AUD or harmful alcohol use receiving psychosocial interventions. Databases searched were PubMed, Embase, Cochrane CENTRAL, and APA PsycInfo. Outcomes assessed were return-to-drinking and abstinence. Risk of bias was evaluated using RoB2 for randomized controlled trials (RCTs) and ROBINS-I for non-RCTs. Meta-analysis was performed using random effects (Knap-Hartung adjustment) and fixed effects (inverse variance) models. Funding was provided by the intramural research program at the National Institute of Diabetes and Digestive and Kidney Diseases. Of 2240 studies reviewed, 20 met the inclusion criteria. Meta-analysis of 7 non-RCTs (n=767) demonstrated a 48% reduction in return-to-drinking risk (relative risk RR=0.52, 95% CI: 0.28-0.99, p=0.048) with significant heterogeneity (I2=74%; p=0.006). Subgroup analyses showed greater return-to-drinking reduction in multidisciplinary care (RR=0.40, 95% CI: 0.31-0.52) and recipients of liver transplant (RR=0.40, 95% CI: 0.27-0.58). Four RCTs found no significant return-to-drinking reduction (RR=0.99, 95% CI: 0.45-2.16, p=0.96). Abstinence was not significantly improved in either RCTs or non-RCTs, with moderate- to low-quality evidence. Psychosocial therapy reduces return-to-drinking risk in chronic liver disease with AUD, particularly within multidisciplinary teams or transplant populations, but findings are tempered by scarce RCT evidence. Future RCTs should evaluate multidisciplinary interventions in transplant populations.

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