Each year in the U.S., more than 40,000 patients need a liver transplant because of complications associated with cirrhosis and liver failure. Alcohol-related liver disease (ALD) alone accounts for nearly 30 percent of all liver transplants, yet up to 50 percent of patients with alcoholism return to drinking within five years of undergoing a liver transplant. Many transplant centers now require a minimum of six months of alcohol abstinence prior to placing candidates on the United Organ Network Sharing waiting list. This pilot study examined the use of text messaging as an alcohol relapse-prevention intervention for patients with ALD scheduled to undergo a liver transplant.
The participants were 15 individuals (11 men and 4 women) diagnosed with ALD who had reported at least one drinking episode in the previous year. They were randomized to receive one of two options for eight weeks: eight candidates received text messages – three text messages/day for the first four weeks of the study, and three messages/week for the last four weeks – and seven candidates received standard care. Assessments were conducted at four and eight weeks. Outcome measures consisted of the percent of messages responded to and post-treatment intervention satisfaction ratings. Clinical outcomes included measures of alcohol consumption, stress, abstinence self-efficacy, and alcohol craving.
Participants who received the text messages reported high satisfaction with the intervention, looked forward to the messages, and found the program easy to complete. This group also had better treatment outcomes than those who received standard care, and they maintained higher levels of self-efficacy and maintained lower stress. The authors believe that mobile cell alcohol interventions may hold significant promise in helping ALD liver-transplant patients maintain sobriety.