title: Implementation of the High-Risk Alcoholism Relapse Scale in a Liver Transplant Clinic.
abstract: Because of the high prevalence of alcohol relapse after liver transplantation, transplant programs are challenged to evaluate alcoholism among liver transplant patients. Relapse after liver transplantation can have detrimental outcomes such as organ rejection, medical and social resource exhaustion, financial burden to the family and society, and negative public perception of organ transplantation. The purpose of this project was to improve post-liver transplant assessment for the risk of relapse to heavy alcohol use by implementing a protocol using the High-Risk Alcoholism Relapse (HRAR) scale (DiMartini et al., 2000; Yates et al., 1993). The project was conducted in an urban organ transplant center's outpatient post liver transplant clinic. Chart reviews assessed the process of patients identified as being at high risk and the transplant providers' completion of the HRAR scale. Eleven percent of patients assessed were identified as being at high risk for relapse of heavy alcohol use and 85% of providers used the HRAR scale in their clinic interviews. This project demonstrates that further refinements in techniques of predicting the risks of relapse are necessary, and nurses are in ideal positions to screen patients for alcohol use.
authors.affiliation: Min Zhou, DNP, RN, ANP-BC, is Nurse Practitioner and Transplant Coordinator, Department of Transplant Surgery, NYU Langone Medical Center and the College of Nursing, New York University, New York. Laura M. Wagner, PhD, RN, GNP, FAAN, is Assistant Professor, Department of Community Health System, School of Nursing, University of California, San Francisco. Thomas Diflo, MD, FACS, is Professor of Surgery, New York Medical College; and Transplant Surgeon, Department of Surgery, Westchester Medical Center, Valhalla, New York. Madeline Naegle, PhD, RN, CNS-PMH, BC, FAAN, is Professor and Program Director, Substance Related Disorders Specialty Sequence, College of Nursing, New York University, New York.
authors.forename: Min
authors.initials: M
authors.lastname: Zhou
authors.forename: Laura M
authors.initials: LM
authors.lastname: Wagner
authors.forename: Thomas
authors.initials: T
authors.lastname: Diflo
authors.forename: Madeline
authors.initials: M
authors.lastname: Naegle
mesh_terms: D000437:Alcoholism / Q000175:diagnosis*; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D011184:Postoperative Period; D012008:Recurrence; D012306:Risk