Grant: Project Grant

Approximately 1 in 4 Canadians is practicing high-risk alcohol drinking (more than 10 drinks a week for women and 15 drinks a week for men) based on the Canadian guidelines. One in 3 people who practice high-risk alcohol consumption, also known as heavy alcohol drinking, has alcohol-related liver disease (ArLD). ArLD accounts for nearly 50% of deaths related to end-stage liver disease. ArLD patients experience worse clinical outcomes compared to other patients with chronic liver disease. The severity of ArLD depends on alcohol consumption and stage of liver scarring, known as fibrosis. Our group was successful to be the first group worldwide to develop a primary care-based pathway for early detection of individuals with ArLD and risk-stratification before they have end-stage liver disease. With the recent increase in alcohol sales, hospitalizations and mortality related to ArLD in Canada, there is an urgent need to lower the risk of worse clinical outcomes among patients with ArLD. In our proposed project, we aim to evaluate, validate and refine the first clinical care pathway to identify and risk-stratify patients with ArLD in primary care in the Calgary Health Zone using simple non-invasive serum markers. Patients at-risk of advanced liver scarring due to ArLD will be connected with multi-disciplinary teams to provide medical and social care. We will evaluate the performance of our clinical pathway and compare two common modalities to risk-stratify liver fibrosis among patients with ArLD (serum-based and ultrasound-based). We ask patients and providers for their feedback through each step of our evaluation, and we aim to integrate and refine the pathway accordingly. This project is novel, timely and essential to meet the urgent and unmet need of identifying and supporting ArLD patients. Doing so will provide these patients with better clinical outcomes and help them reach low-risk alcohol consumption targets.