P76 Effectiveness of advice based on liver disease diagnostic tests on managing high risk drinking behaviour in patients with alcohol misuse: a systematic review with met analysis

Background and Aims Alcohol dependence is cause of major public health concern and a growing global pandemic affecting over 240 million people worldwide and attributed to 3 million deaths annually. Early identification and intervention is key to prevent future harm. There is established evidence from other specialities on usefulness of biofeedback based on investigations or severity of disease in modifying patient high risk behaviour, but this practice is lacking in alcohol misuse service. We aim to systematically review published literature on effectiveness of adding advice based on liver disease diagnostic tests or marker of liver injury to decrease alcohol consumption and/or to prevent alcohol misuse. Methods The protocol was registered on Prospero (CRD42020164185). A systematic search strategy was developed, and an electronic search was conducted across Ovid Medline, PubMed, EMBASE, Psychinfo and CINAHL from inception to end February 2020. Additionally, we searched: citations of included studies, Scopus conferences proceeding, Ethos for grey literature and Clinicaltrials.gov. Primary outcome measures included change alcohol use and gamma glutamyl transferase (GGT). A random effect metanalysis was performed in Cochrane Review manager (version 5.3). The risk of biased was assessed using Cochrane risk of bias assessment tools and quality of studies was assessed by GRADE system. Results 20 papers of 14 randomised controlled trials (RCT) and two observational studies comprising n=3763 participants were included. The weighted mean average difference for weekly alcohol intake between intervention and comparison group was -74.4 gram/week (95%CI -126.1, -22.6) (p=0.005), and for GGT was -19.7 IU/L (95% CI -33.1, -6.4) (p=0.004). There was higher incident of alcohol attributed mortality, number days spent in hospital, physician visits and sickness absence in non-intervention group. The quality of included studies was moderate for RCT’s and high for observational studies. Conclusions The review confirmed a significant association between addition of advice based on liver disease diagnostic tests or marker of liver injury in routine care in the reduction or/and abstinence of alcohol consumption, GGT and alcohol related mortality. This supports the integration of such interventions into alcohol misuse services.