The goal of this clinical trial is to learn if it is feasible and acceptable to use a recovery coach and an online sober active community to help with alcohol use disorder after liver transplant. The main questions it aims to answer are: * Is using a recovery coach after liver transplant to help with alcohol use recovery feasible and acceptable? * Is using an online sober active community after liver transplant to help with alcohol use recovery feasible and acceptable? Researchers will compare standard of care including a recovery coach alone to a recovery coach plus to assist with recovery from alcohol use recovery after liver transplant Participants will: * Work with a recovery coach including a weekly phone call * Visit the clinic once every 3 months for a checkup and to complete surveys * If randomized to the intervention arm, download an online application with access to a digital sober active community
Rates of alcohol use disorder and alcohol associated liver disease requiring liver transplantation continue to rapidly rise. Return to alcohol use after liver transplant is associated with increased rates of liver transplant failure and mortality, but there is no evidence-based integrated intervention to address alcohol use disorder in liver transplant recipients. The goal of this pilot feasibility randomized control trial is to address a critical gap in knowledge and care for liver transplant recipients with concurrent alcohol use disorder by developing and pilot testing an integrated liver transplant and alcohol recovery program (ILTARP) consisting of a recovery coach supporting post-transplant alcohol relapse prevention, outreach, and care coordination with the added intervention of access to an active sober community. The investigators will conduct a pilot feasibility study of the newly developed ILTARP intervention testing feasibility, acceptability, and potential effectiveness of ILTARP in the liver transplant clinical setting.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
40
Participants will have access to an online sober active community that they can use to augment their recovery process.
Participants will work with a recovery coach including having weekly phone calls with that recovery coach.
Vanderbilt University Medical Center
Nashville, Tennessee, United States
Acceptability of ILTARP (The perception that ILTARP is palatable, agreeable, or satisfactory)
Measured by the Acceptability of Intervention Measure (AIM) survey. The scale ranges from 3 to 15 with a high score indicating greater acceptability.
Time frame: Baseline, month 3, month 6, month 9, and study end (1 year)
Feasibility of ILTARP (the degree to which ILTARP can be carried out successfully)
Measured by the Feasibility of Intervention Measure (FIM) survey. The scale ranges from 3 to 15 with a high score indicating greater feasibility.
Time frame: Baseline, month 3, month 6, month 9, and study end (1 year)
Appropriateness of ILTARP (ILTARP suitability and relevance)
Measured by the Intervention Appropriateness Measure (IAM).The scale ranges from 3 to 15 with a high score indicating greater appropriateness.
Time frame: Baseline, month 3, month 6, month 9, and study end (1 year)
Alcohol use clinically based on lab
the lab test phosphatidylethanol will be used to assess alcohol use
Time frame: Baseline, month 3, month 6, month 9, and study end (1 year)
Alcohol use based on self report
Alcohol use will be self reported using the Alcohol Use Disorders Identification (AUDIT-C) scale. The scale ranges from 0 to 12 with 0 being the lowest amount of alcohol and 12 being the most amount of alcohol.
Time frame: Baseline, month 3, month 6, month 9, and study end (1 year)
Alcohol cravings based on self report
Alcohol cravings will be self reported using the Penn Alcohol Craving Scale (PACS). Scale score ranges from 0-30 with 0 being the least amount of cravings and 30 the most.
Time frame: Baseline, month 3, month 6, month 9, and study end (1 year)
engagement in recovery resources
Participants will complete a survey on their engagement in recovery resources.
Time frame: Baseline, month 3, month 6, month 9, and study end (1 year). The participants will select what resources they have used and how often they have been used. This is not a summarized scale therefore there is not a better or worse outcome.
clinic and lab adherence
The number of missed lab appointments and transplant clinic no-show rates will be calculated from the medical record.
Time frame: Baseline, month 3, month 6, month 9, and study end (1 year)
medication adherence
Tacrolimus levels will be obtained from the medical record to calculate tacrolimus intrapatient variability.
Time frame: Baseline, month 3, month 6, month 9, and study end (1 year)
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