Awareness and opinions of non-alcoholic fatty liver disease by hospital specialists

Bergqvist, C. -J., Skoien, R., Horsfall, L., Clouston, A. D., Jonsson, J. R. and Powell, E. E. (2013) Awareness and opinions of non-alcoholic fatty liver disease by hospital specialists. Internal Medicine Journal, 43 3: 247-253. doi:10.1111/j.1445-5994.2012.02848.x


Author Bergqvist, C. -J.
Skoien, R.
Horsfall, L.
Clouston, A. D.
Jonsson, J. R.
Powell, E. E.
Title Awareness and opinions of non-alcoholic fatty liver disease by hospital specialists
Journal name Internal Medicine Journal   Check publisher's open access policy
ISSN 1444-0903
1445-5994
Publication date 2013-03-01
Year available 2013
Sub-type Article (original research)
DOI 10.1111/j.1445-5994.2012.02848.x
Volume 43
Issue 3
Start page 247
End page 253
Total pages 7
Place of publication Richmond, VIC Australia
Publisher Wiley-Blackwell Publishing Asia
Language eng
Formatted abstract
Background/Aim: Subjects with metabolic risk factors for non-alcoholic fatty liver disease (NAFLD) are commonly seen by hospital specialists other than gastroenterologists/hepatologists. The aim of this study was to assess the awareness of NAFLD and opinions regarding management among non-hepatologists at two major tertiary hospitals in Brisbane.

Methods:
A face-to-face questionnaire assessing current beliefs and practices regarding NAFLD was administered to specialists and specialists-in-training across six specialties (internal medicine, cardiology/cardiac surgery, endocrinology, thoracic medicine, rheumatology and nephrology).

Results: One hundred clinicians were surveyed with 99% returning completed questionnaires (>89% questions answered). The majority of respondents (75%) believe the prevalence of NAFLD in the general population to be ≤10%, although two-thirds feel that its incidence will rise markedly. The vast majority (>90%) appreciate that traditional cardiovascular risk factors (obesity, hypertriglyceridaemia and diabetes) are risk factors for NAFLD and acknowledge that these are common in non-hepatology patients. Despite this, most believe that NAFLD is uncommon in their own patients (89% indicated a prevalence ≤30%). The vast majority (93%) agree that non-alcoholic steatohepatitis (NASH) is associated with increased overall mortality, but 60% also believe that simple steatosis confers increased liver-related mortality. Most (74%) agree that a diagnosis of NASH cannot be made using liver enzymes, but 67% support 6-monthly liver function tests as the most effective way to monitor progression of NAFLD. Most respondents (71%) make no referrals to hepatology for suspected NAFLD.

Conclusions: Non-hepatologists appreciate the seriousness of NAFLD but appear to underestimate its prevalence, especially among their own patients despite known risk factors. Attitudes regarding simple steatosis versus NASH and appropriate monitoring of suspected NAFLD suggest that more can be done to improve the understanding of this disease among non-hepatologists. This has implications for targeting 'at-risk' populations and appropriate referral of patients to hepatology clinics.
Keyword Screening
Survey
Metabolic syndrome
Cardiovascular Disease
General practitioners
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
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