The public health impact of alcohol-associated liver disease (ALD), a serious consequence of problematic alcohol use, and alcohol use disorder (AUD) is growing, with ALD becoming a major cause of alcohol-related death overall and the leading indication for liver transplantation in the United States. Comprehensive care for ALD often requires treatment of AUD. Although there is a growing body of evidence showing that AUD treatment is associated with reductions in liver-related morbidity and mortality, only a minority of patients with ALD and AUD receive this care. Integrated and collaborative models that streamline both ALD and AUD care for patients with ALD and AUD are promising approaches to bridge this treatment gap and rely on multidisciplinary and interprofessional teams and partnerships. Here, we review the role of AUD care in ALD treatment, the effects of AUD treatment on liver-related outcomes, the impact of comorbid conditions such as other substance use disorders, obesity, and metabolic syndrome, the current landscape of integrated and collaborative care for ALD and AUD in various treatment settings. We further review knowledge gaps and unmet needs that remain, including the role of precision medicine, the application of harm reduction approaches, the impact of health disparities, the need for additional AUD treatment options as well as further efforts to support implementation and dissemination.

中文翻译：

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酒精相关性肝病和酒精使用障碍的综合和协作护理


酒精相关性肝病 (ALD) 是有问题的饮酒的严重后果，酒精使用障碍 (AUD) 对公共健康的影响正在不断加大，其中 ALD 已成为总体上与酒精相关的死亡的主要原因，也是肝病的主要适应症。在美国移植。 ALD 的综合护理通常需要 AUD 治疗。尽管越来越多的证据表明 AUD 治疗可降低肝脏相关发病率和死亡率，但只有少数 ALD 和 AUD 患者接受这种治疗。简化对 ALD 和 AUD 患者的 ALD 和 AUD 护理的综合协作模型是弥合这一治疗差距的有前途的方法，并依赖于多学科和跨专业团队和合作伙伴关系。在这里，我们回顾了 AUD 护理在 ALD 治疗中的作用、AUD 治疗对肝脏相关结局的影响、其他物质使用障碍、肥胖和代谢综合征等共病的影响、综合和协作护理的现状适用于各种治疗环境中的 ALD 和 AUD。我们进一步审查仍然存在的知识差距和未满足的需求，包括精准医疗的作用、减少危害方法的应用、健康差异的影响、额外 AUD 治疗方案的需要以及支持实施和传播的进一步努力。