A87 CHANGES IN CLINICIAN KNOWLEDGE, COMFORT, PREPAREDNESS, AND ATTITUDES ABOUT ALCOHOL USE DISORDER AND CIRRHOSIS AFTER A BRIEF EDUCATIONAL INTERVENTION

Abstract

BackgroundAlcohol use disorder (AUD) is increasing in prevalence and has a substantial impact on morbidity and mortality in people with cirrhosis. The use of screening, brief intervention and referral to treatment (SBIRT) and relapse prevention medications (e.g. acamprosate) are recommended by recent guidelines. Unfortunately, many clinicians report insufficient training to feel confident using these interventionsAimsWe aimed to compare the effect of a brief educational intervention on AUD knowledge, comfort, attitudes, and preparedness in clinicians who provide care to patients with cirrhosis.MethodsClinicians were invited to participate in a 1.5-hour educational session conducted by a hepatologist and addiction medicine specialist. The session included information about SBIRT and pharmacotherapy. Pre-training knowledge, comfort, and practice behaviors were assessed using previously published questions. Baseline attitudes were measured using the Short Alcohol and Alcohol Problems Perception Questionnaire. Participants were invited to repeat the questionnaires immediately post-training and statistical analysis conducted.ResultsEighty-two clinicians attended the session. Among the 38 attendees who completed both the pre- and post-questionnaires, 34% were GIs/internists, 45% were family medicine physicians, and the remainder (21%) did not specify or were not prescribers. Scores for self-reported intention and preparedness to treat AUD, comfort, and knowledge improved significantly from the pre-training phase. Attitudes also improved from the pre-training phase, with significant improvements in the SAAPPQ subscales of role adequacy (p=0.03) and motivation (p=0.04).ConclusionsRecognizing the small sample size, a brief educational session demonstrated promising results in the promotion of knowledge, attitudes, preparedness, and comfort for clinicians managing AUD in patients with cirrhosis. Feedback from these sessions will be used to design an accredited educational series for roll-out in 2022.Table 1. Paired samples t-test pre and post preparedness, intention and comfort questionsPre-test mean (SD)Post-test mean (SD)P-valueEffect size IntentionTo screen every patient for AUD5.0 (1.2)5.7 (.74)<0.0010.702Provide medical advice about AUD5.4 (1.0)5.8 (0.56)0.0970.494Provide a brief intervention5.3 (.93)5.7 (.68)0.0090.491Prescribe anti-relapse medications4.6 (1.5)5.2 (1.2)0.0280.442PreparednessTo screen and diagnose AUD3.3 (.85)3.8 (.39)0.001.756To provide a brief intervention2.8 (.91)3.6 (.50)<0.0011.09To refer patients for treatment3.0 (.96)3.6 (.50)0.001.784ComfortPrescribing Acamprosate2.4 (.82)3.2 (.75)<0.0011.018Prescribing Baclofen2.2 (.62)3.0 (.68)<0.0010.279Prescribing Gabapentin2.5 (.65)3.1 (.67)<0.0010.909Funding AgenciesAlberta Innovates Health Solutions