Abstract:
BACKGROUND:Non-alcoholic fatty liver disease (NAFLD) is a common cause of incidental liver test abnormalities. General practitioners (GP) have a key role in identifying people with NAFLD at risk of significant liver disease. Recent specialist guidelines emphasise the use of fibrosis algorithms or serum biomarkers rather than routine liver tests, to assess advanced fibrosis. AIM:To evaluate primary care clinicians' current approach to diagnosis, management and referral of NAFLD. METHODS:A cross-sectional survey of primary care clinicians was undertaken through a structured questionnaire about NAFLD. A convenience sample of general practice clinics and general practice conferences in Metropolitan Brisbane and regional south east Queensland was selected. RESULTS:A total of 108 primary care clinicians completed the survey (participation rate 100%). Fifty-one percent of respondents considered the prevalence of NAFLD in the general population to be ≤10%. Twenty-four percent of respondents felt that liver enzymes were sufficiently sensitive to detect underlying NAFLD. Most respondents were unsure whether the Fibrosis 4 score (62.7% unsure) or Enhanced Liver Fibrosis score (63.7% unsure) could help to identify advanced fibrosis or cirrhosis. Although 47% of respondents said they would refer a patient to a Gastroenterologist/Hepatologist if they suspect the patient has NAFLD, 44.1% do not make any referrals. Of concern, 70.6% of clinicians said they were unlikely to refer a patient to Hepatology unless liver function tests are abnormal. CONCLUSION:Our findings demonstrate that many primary care clinicians underestimate the prevalence of NAFLD and under-recognise the clinical spectrum of NAFLD and how this is assessed.
journal_name
Intern Med Jjournal_title
Internal medicine journalauthors
Patel PJ,Banh X,Horsfall LU,Hayward KL,Hossain F,Johnson T,Stuart KA,Brown NN,Saad N,Clouston A,Irvine KM,Russell AW,Valery PC,Williams S,Powell EEdoi
10.1111/imj.13667subject
Has Abstractpub_date
2018-02-01 00:00:00pages
144-151issue
2eissn
1444-0903issn
1445-5994journal_volume
48pub_type
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