Nearly 90% of liver transplant center websites still use alcohol-stigmatizing language
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Key takeaways:
- Researchers reported stigmatizing language used on 87.8% of transplant websites vs. 46.2% of addiction psychiatry websites.
- This finding comes despite medical societies recommending non-stigmatizing language.
A “vast majority” of liver transplant centers use stigmatizing language, such as “alcoholic” or “alcohol abuse,” when describing patients with alcohol use disorder and alcohol-associated liver disease on their websites, researchers reported.
“Our team embarked on this investigation driven by both professional observations and personal experiences in the field of liver transplantation, particularly at a time when alcohol-associated liver disease (ALD) has become the leading indication for liver transplants,” Wei Zhang, MD, PhD, director of the Alcohol-Associated Liver Disease Clinic and transplant hepatologist at Massachusetts General Hospital, told Healio. “Despite this, the pervasive stigma surrounding ALD significantly hinders many patients’ ability to receive a lifesaving transplant.”
Zhang continued: “The use of biased terms by health care providers, sometimes unconsciously, can significantly disadvantage these patients, undermining their chances for a transplant. This stigma can lead to delays in seeking care or being evaluated for transplantation, and in some instances, it has resulted in preventable loss of life.”
In a cross-sectional study published in JAMA Network Open, Zhang and colleagues investigated use of non-stigmatizing language recommendations across the websites of 114 accredited U.S. liver transplant centers and 104 addiction psychiatry departments in the same health care systems. Researchers categorized each website as using stigmatizing language, non-stigmatizing language or a combination of the two.
According to results, 71.9% of liver transplant centers described AUD, ALD, alcohol-associated hepatitis and/or alcohol-associated cirrhosis, while 37.5% of addiction psychiatry centers described AUD. Of the 82 transplant and 39 addiction psychiatry websites reviewed, 87.8% and 46.2%, respectively, used stigmatizing language.
“A vast majority of liver transplant centers utilized stigmatizing language, such as ‘alcoholism,’ ‘alcoholic’ and ‘alcohol abuse,’ when describing patients with AUD and ALD on their websites,” Zhang said. “This was evident despite medical societies recommending the use of non-stigmatizing terms like ‘alcohol use disorder’ and 'alcohol-associated liver disease.’”
When describing AUD, liver transplant websites used only stigmatizing language 79.2% of the time, while non-stigmatizing and mixed language was used 20.8% and 0%, respectively. This finding was “significantly higher” than addiction psychiatry websites, which used only stigmatizing language 30.8% of the time.
For ALD and alcohol-associated hepatitis, 66.7% and 95.7% of websites used only stigmatizing language, respectively, 20% and 2.1% used only non-stigmatizing language and 13.3% and 2.1% used a combination of the two. The term “alcoholic cirrhosis” was used on 85.7% of websites, while 10.7% and 3.6% used non-stigmatizing and mixed language.
“The widespread use of stigmatizing language potentially contributes to the stigma associated with AUD and ALD, which can deter patients from seeking the care they need and affect their eligibility for liver transplantation,” Zhang told Healio. “The study calls on liver transplant centers and the broader medical community to reassess and update their communication practices.”
He added, “By aligning language use with non-stigmatizing guidelines, we can create a more inclusive, supportive environment for patients, encouraging timely care-seeking and potentially improving treatment outcomes.”
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