2 - (SYM 94) Pilot Outcomes of a Brief Treatment for Alcohol Misuse and Cardiovascular Disease Risk in Integrated Treatment Settings

Background: Much of the negative health impact of unhealthy alcohol use on a population level relates to its association with uncontrolled blood pressure. Yet treatment models for unhealthy alcohol use and uncontrolled blood pressure almost always consider the two conditions separately. The current study sought to pilot a brief treatment for alcohol misuse and elevated cardiovascular disease (CVD) risk and understand patient experiences during this treatment.

Methods: Six Veterans Affairs (VA) patients with unhealthy alcohol use (a yearly Alcohol Use Disorder Identification Test-Consumption [AUDIT-C] ≥ 5) and uncontrolled blood pressure (multiple in-clinic measurements ≥ 140/90 mmHg) participated in treatment. Treatment consisted of four sessions of Cognitive Behavioral Therapy for alcohol use, one transitional coaching session for CVD risk with referrals, and one month of text messages based on patient-generated prompts. Quantitative data were collected at baseline, end of treatment (EOT), and 3-month follow-up, and qualitative interviews were conducted at EOT.

Results: Patient age was 61.5 yrs (SD=6.35), majority African American (N=5), and male (N=4). Patients reported a mean of 0.8 past-month heavy drinking days (SD=1.30) at EOT, and 2.33 (SD=4.8) at 3 months. At EOT and 3-month follow-up, four patients (66.6%) reported 0 heavy drinking days in the past 30 days. Patients reported an average decrease of 1.8 past-month drinks per day (SD=1.64) at EOT, and 2.7 (SD=1.51) at 3 months. Average chart-reviewed blood pressure at baseline was 155.8/74.8 mmHg, which decreased to 136.2/84.8 mmHg at latest visit between after EOT. Four patients’ (66.6%) latest charted blood pressure was no longer uncontrolled. Patients’ attitudes toward the treatment were mixed at discharge, but improved on questionnaires at 3-month follow-up. Qualitative interview coding is in-process.

Conclusion: This pilot treatment found preliminary evidence that patients’ alcohol use and blood pressure both declined meaningfully during treatment and follow-up. Additionally, non-treatment-seeking patients were highly willing to engage throughout brief treatment, but some reported initial dissatisfaction with the treatment process followed by improved satisfaction. Larger trials should be conducted with randomized control groups to gather more evidence on the generalizability and causality of improvements in brief integrated treatment for unhealthy alcohol use and CVD risk.

Trial Registration: ClinicalTrials.gov Identifier: NCT04838457