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Lookup NU author(s): Dr Laura Neilson, Dr Louise MacDougall, Dr Timothy Hardy, Dr David Beaton, Dr April Phaw, Laura Haigh, Dr Kate HallsworthORCiD, Dr Diana Mansour, Dr Jess Dyson, Dr Steven MassonORCiD, Professor Quentin AnsteeORCiD, Professor Stuart McPhersonORCiD
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Background: Non-alcoholic fatty liver disease (NAFLD) is common and is associated with liver-related and cardiovascular-related morbidity. Our aims were: (1) to review the current management of patients with NAFLD attending hospital clinics in North East England (NEE) and assess the variability in care; (2) develop a NAFLD 'care bundle' to standardise care; (3) to assess the impact of implementation of the NAFLD care bundle. Methods: A retrospective review was conducted to determine baseline management of patients with NAFLD attending seven hospitals in NEE. A care bundle for the management of NAFLD was developed including important recommendations from international guidelines. Impact of implementation of the bundle was evaluated prospectively in a single centre. Results: Baseline management was assessed in 147 patients attending gastroenterology, hepatology and a specialist NAFLD clinic. Overall, there was significant variability in the lifestyle advice given and management of metabolic risk factors, with patients attending an NAFLD clinic significantly more likely to achieve >10% body weight loss and have metabolic risk factors addressed. Following introduction of the NAFLD bundle 50 patients were evaluated. Use of the bundle was associated with significantly better documentation and implementation of most aspects of patient management including management of metabolic risk factors, documented lifestyle advice and provision of NAFLD-specific patient advice booklets. Conclusion: The introduction of an outpatient 'care bundle' led to significant improvements in the assessment and management of patients with NAFLD in the NEE and could help improve and standardise care if used more widely.
Author(s): Neilson LJ, MacDougall L, Lee PS, Hardy T, Beaton D, Chandrapalan S, Ebraheem A, Hussien M, Galbraith S, Looi S, Oxenburgh S, Phaw NA, Taylor W, Haigh L, Hallsworth K, Mansour D, Dyson JK, Masson S, Anstee Q, McPherson S
Publication type: Article
Publication status: Published
Journal: Frontline Gastroenterology
Year: 2021
Volume: 12
Issue: 7
Pages: 578-585
Print publication date: 01/12/2021
Online publication date: 04/01/2021
Acceptance date: 08/10/2020
Date deposited: 19/03/2021
ISSN (print): 2041-4137
ISSN (electronic): 2041-4145
Publisher: BMJ Publishing Group
URL: https://doi.org/10.1136/flgastro-2020-101480
DOI: 10.1136/flgastro-2020-101480
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