Liver image edited hepatology

A psychological therapy found to be effective in helping people achieve and maintain weight loss is being trialled to see if it can support patients with chronic liver disease to stop drinking.

Functional Imagery Training (FIT), developed by researchers at the University of Plymouth and Queensland University of Technology, uses mental imagery to motivate behaviour change.

Unlike other types of ‘brief counselling therapy’, FIT teaches people how to create motivational imagery themselves. This allows them to use visualisation techniques on their own when faced with challenges, which can support long-term behaviour change.

Now, thanks to funding from the Jon Moulton Charity Trust, a pilot randomised controlled trial will examine whether FIT could be used to help patients admitted to hospital with alcohol-related liver disease (ArLD) to stop drinking.

Beginning later this year, the project will aim to recruit 90 patients admitted to hospital in Plymouth, Bristol and Leeds. All will receive the usual treatment - Brief Intervention, a form of motivational interviewing signposting patients to community services - and half will also be randomly selected to receive FIT.

Researchers will collect information on alcohol use, use of health and social care services and costs of care to patients and their families over the six-month treatment period.

If the pilot is successful, it will be used to plan a larger trial to test whether FIT is effective in helping patients with ArLD to stop drinking.

The project is being led by Dr Ashwin Dhanda, Honorary Associate Professor in Hepatology at the University of Plymouth and a Consultant at University Hospitals Plymouth NHS Trust and Professor Jackie Andrade from the University’s School of Psychology, one of the co-creators of FIT.

Dr Dhanda said:

“Alcohol use is the commonest cause of liver disease in the UK and results in over 60,000 hospital admissions each year. It is the third biggest cause of premature death in the UK and has huge financial implications for the NHS and wider society.

“For patients admitted to hospital having reached a crisis point in their ArLD, continuing to drink will lead to decreasing quality of life and an early death. The only way to prevent this is reducing or stopping alcohol, and that is why we are so excited to be testing this new approach in these patients.”

Professor Andrade added:

“Having seen such encouraging results with FIT in a weight loss trial, we have been keen to test the intervention in a different group of patients, with a different kind of damaging behaviour.

“This research addresses the overwhelming need for a new treatment approach that capitalises on patients’ receptiveness to change immediately after an unplanned hospital admission, but crucially continues to offer support beyond discharge, to reduce the numbers who relapse.”

The study will be run with the support of the Peninsula Clinical Trials Unit, part of the University’s Faculty of Health. PenCTU is one of 47 fully UK Clinical Research Collaboration (UKCRC)-registered clinical trials units in the UK, which have been set up with a specific remit to design, conduct, analyse and publish clinical trials and other well-designed studies. PenCTU helped to develop the successful funding application and will support the delivery of the project by providing expert clinical trial management, development of data capture systems, data management, methodological expertise and statistical analysis.  

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