Investigators have found that stigmatizing language on transplant websites may deter patients with alcohol use disorder and alcohol-associated liver disease from seeking necessary medical care, according to a recent study published by Mahle et al in JAMA Network Open. Many liver disease societies currently advise transplant center websites on the use of nonstigmatizing language; however, the extent of adherence to that guidance is unknown. In a cross-sectional study, investigators examined the language used on the websites of 114 accredited U.S. liver transplant centers and 104 addiction psychiatry services offered at the same institutions. They searched for stigmatizing vs nonstigmatizing words and phrases such as “alcoholism” and “alcohol abuse” vs “alcohol use disorder,” “alcohol misuse,” and “alcohol-associated.” The investigators noted that 71.9% (n = 82) of the liver transplant centers described alcohol use disorder, alcohol-associated liver disease, alcohol-associated hepatitis, and alcohol-associated cirrhosis; whereas 37.5% (n = 39) of the addiction psychiatry services described alcohol use disorder without discussing liver disease on their websites. Among these, 87.8% (n = 72/82) of the liver transplant center websites and 46.2% (n = 18/39) of the addiction psychiatry service websites included stigmatizing language. Further, 79.2% (n = 42/53) of the language centered around alcohol use disorder was stigmatizing, while only 20.8% (n = 11/53) was considered nonstigmatizing. On websites describing alcohol-associated liver disease, alcohol-associated hepatitis, and alcohol-associated cirrhosis, 66.7% (n = 40/60), 95.7% (n = 45/47), and 85.7% (n = 24/28) of them employed stigmatizing language; 20.0% (n = 12/60), 2.1% (n = 1/47), and 10.7% (n = 3/28) of them employed nonstigmatizing language; and 13.3% (n = 8/60), 2.1% (n = 1/47), and 3.6% (n = 1/28) of them employed a mix of both, respectively. The findings highlighted inconsistencies in the adoption of nonstigmatizing language across liver transplant centers and their corresponding addiction psychiatry services. Delayed interventions among patients with alcohol-associated liver disease may be linked to stigmatizing language perpetuated on these websites. The investigators concluded that the use of patient-centered language on these resources may help reduce stigma and improve care among this patient population.
Lack of Widespread Adoption of Nonstigmatizing Language on Liver Transplant Center Websites
Conexiant
April 26, 2024