Alcohol-related Liver Disease: Guidance for Good Practice

SHAAP (Scottish Health Action on Alcohol Problems) recently launched new guidance on liver disease which aims to ensure consistency in approaches to prevention, treatment, care, support and recovery.

Download ‘Alcohol-related Liver Disease: Guidance for Good Practice’ [pdf]

SHAAP highlight liver disease is one of the few major causes of premature mortality that is increasing as deaths from liver disease reach record levels. Mortality rates from Alcoholic Liver Disease (ALD) in Scotland have tripled since 1981 and in 2016 ALD accounted for 58% of all alcohol-related deaths in Scotland. Hospital admissions for ALD have more than quadrupled since 1981/2 whilst treatment for alcohol-related conditions in Scotland costs over £1m a day.

The report was produced by clinicians, academics and health professionals specialising in liver care and public health, and included a national consultation event in 2016. Report recommendations include:

• Specialist alcohol services should prioritise patients with evidence of alcohol-related liver damage for intervention. Services should actively, repeatedly and assertively engage with clients with alcohol-related liver damage.
• Patients admitted to hospital with alcohol-related liver failure should be managed immediately, in accordance with national guidelines, be reviewed by a physician with expertise in liver disease and be engaged with an alcohol treatment service prior to discharge.
• Health Boards and Integrated Joint Boards should facilitate the organisation of services to allow the operation of the care pathway recommendations.

Earlier this year a UK Lancet Commission report on the 'Financial case for action on liver disease' predicted 63,000 alcohol-related deaths over the next five years. Previously a report New metrics for the Lancet Standing Commission on Liver Disease in the UK also called for further action at both regional and national level, including policies to curb overall alcohol consumption.

Public Health England (PHE) have also recently updated local figures on liver disease, with various media reporting on the wide regional variation seen. Those who have been calling for further action to address the burden of liver disease will no doubt be eagerly anticipating the final ruling of Scotland's long running minimum unit pricing (MUP) battle given expectations for MUP to play a significant role in the future alcohol-related liver disease rates in Scotland.