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Understanding alcohol-related liver disease patients’ illness beliefs

Survey measured patients' views about medicines relating to alcoholic liver disease

Survey measured patients' views about medicines relating to alcoholic liver disease


Alcoholic liver disease is a major complication of alcohol misuse. Picture: iStock

Alcoholic liver disease is a chronic condition and patients are often required to take medications, including diuretics and laxatives, for the rest of their lives. These require constant monitoring and titrating. They have considerable side effects while the benefits, particularly as symptoms of the disease may not be severe, are not obvious to patients.

It has been estimated that 30% to 50% of all patients, including those with alcoholic liver disease, do not take their treatment as prescribed. This survey aimed to explore factors related to non-adherence. Patients attending a liver outpatients’ clinic at a London hospital were invited to complete a set of validated instruments measuring illness beliefs and views about their medicines.

Of the 159 participants, 59 were over the age of 55 with the oldest being 80 years of age. Findings showed that patients did not feel they were in control of their illness, and had little understanding of it. This is important because those with good ‘illness comprehension’ were shown to be less concerned about the negative effects of their medication.

Patients’ beliefs about their medicine were significantly more influenced by their experience of symptoms than by the underlying severity of the disease. For patients with alcoholic liver disease, acceptance is complicated as they may be virtually asymptomatic until the end stages and the label of ‘alcoholic’ brings negative connotations that can be difficult for patients to accept.

Medication adherence is likely to be improved by increasing patients’ understanding of their illness.


Presky J, Webzell I, Murrells T et al (2018) Understanding alcohol-related liver disease patients’ illness beliefs and views about their medicine. British Journal of Nursing. 27, 13, 730-736.

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