Oral health status and treatment needs among adults seeking dental anxiety treatment in general practice - a cross-sectional study.

Patients with alcohol-associated liver disease frequently experience stigma in the health care setting. Stigma impacts patients across the care continuum, including health care–seeking behaviors, engagement in health care, treatment adherence, and clinical outcomes. Stigma can manifest not only through direct patient-provider interactions but also through clinical documentation. In recognition of the negative impacts of stigmatizing language in alcohol-associated liver disease care, recommendations from professional societies advocate for the elimination of stigmatizing language in alcohol use disorder. Major liver-related professional societies and national organizations caution against the use of terms such as “alcoholic,” “alcohol abuse,” and “clean,” and instead recommend the use of nonstigmatizing terms such as “alcohol use disorder,” “alcohol associated liver disease,” and “abstinence.” Despite these recommendations, a recent study comparing the use of stigmatizing language on patient-facing liver transplant center websites and addiction psychiatry websites identified that 87% and 46%, respectively, of these websites still used stigmatizing language in discussing alcohol use disorder. The number of patients accessing clinical documentation through the patient portal has expanded significantly over time. As a result, notes that were historically used as provider-provider communication are now readily accessible to patients to review, creating a new and underrecognized potential source of stigma. Given increasing patient portal (portal) use among persons with cirrhosis, stigmatizing language in hepatology clinic notes may serve as an additional and modifiable source of stigma that has not been fully characterized. Herein, we evaluate the presence and patterns of alcohol-related stigmatizing language in liver clinic notes for patients with alcohol-associated cirrhosis.