Repeated Brief Counseling Decreases Recurrence of Alcohol-Related Pancreatitis

Alcohol-related acute pancreatitis commonly recurs, and continued alcohol use is associated with recurrence. Finnish investigators randomized patients hospitalized for alcohol-related acute pancreatitis to either a single 30-minute in-hospital session of brief counseling (n=61) or the same counseling session plus repeated counseling every 6 months in the gastroenterology outpatient clinic (n=59). Subjects were 84% men, and the median age for all participants was 47. Patient characteristics (demographics, alcohol use, and severity of disease) were similar between groups. At 2-year follow-up,

• 23 patients were rehospitalized for abdominal complaints (12% of the repeated intervention group and 26% of the single intervention group) (p=0.038).

• 18 patients developed recurrent acute pancreatitis (8% of the repeated intervention group and 21% of the single intervention group) (p=0.042).

• dependence symptoms decreased significantly in the repeated intervention group, where a trend toward lower consumption was also observed.

Comments:

This study strongly suggests the importance of ongoing brief counseling over time to maximize benefits. It further suggests that counseling should not be “relegated” to primary care physicians but can be useful for medical specialists like gastroenterologists who follow patients with pancreatitis and alcoholic liver disease. Future studies should examine whether brief interventions would similarly benefit patients with alcohol-related conditions seen by other specialists; e.g., holiday heart syndrome and alcoholic cardiomyopathy by cardiologists and alcoholrelated seizures by neurologists. Peter D. Friedmann, MD, MPH

Reference:

Nordback I, Pelli H, Lappalainen Lehto R, et al. The recurrence of acute alcohol-associated pancreatitis can be reduced: a randomized controlled trial. Gastroenterology. 2009;136(3):848–855.