INTRODUCTION: Identify predictors of motivation to reduce alcohol consumption, and whether motivation predicts engagement in alcohol misuse treatment in alcohol-related liver disease (ALD).

METHODS: Data from health surveys and healthcare registries were combined.

RESULTS: Of 674 ALD patients, 65% consumed alcohol. Recent hospital admission and severe alcohol problems were associated with motivation to reduce. Two-year probability for engagement in misuse treatment was 29% for patients with motivation to reduce versus 6.5%.

DISCUSSION: ALD patients with recent hospital admission were more motivated to cut down, and motivation predicted engagement in alcohol misuse treatment. This insight can help us target brief interventions.