Defining comprehensive models of care for NAFLD.

Jeffrey V Lazarus, Quentin M Anstee, Hannes Hagström, Kenneth Cusi, Helena Cortez-Pinto, Henry E Mark, Michael Roden, Emmanuel A Tsochatzis, Vincent Wai-Sun Wong, Zobair M Younossi, Shira Zelber-Sagi, Manuel Romero-Gómez, Jörn M Schattenberg

Journal: Nature reviews. Gastroenterology & hepatology 2021;18(10):717-729

PMID: 34172937

Full Text on Nature Publishing Group View on PubMed

Abstract

Non-alcoholic fatty liver disease (NAFLD) is now the leading cause of chronic liver disease globally. Despite the increased demand placed on health-care systems, little attention has been given to the design and implementation of efficient and effective models of care for patients with NAFLD. In many health-care settings, no formal pathways exist and, where pathways are in place, they are often not standardized according to good practices. We systematically searched the peer-reviewed literature with the aim of identifying published examples of comprehensive models of care that answered four key questions: what services are provided? Where are they provided? Who is offering them? How are they coordinated and integrated within health-care systems? We identified seven models of care and synthesized the findings into eight recommendations nested within the 'what, where, who and how' of care models. These recommendations, aimed at policy-makers and practitioners designing and implementing models of care, can help to address the increasing need for the provision of good practice care for patients with NAFLD.

Address: Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain. [email protected].; EASL International Liver Foundation, Geneva, Switzerland. [email protected].; Translational & Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom.; The Liver Unit & NIHR Biomedical Research Centre, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom.; Karolinska Institute, Stockholm, Sweden.; Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, Veterans Health Administration and University of Florida, Gainesville, FL, United States.; Clínica Universitária de Gastrenterologia, Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.; EASL International Liver Foundation, Geneva, Switzerland.; Department of Endocrinology and Diabetology, Medical Faculty and University Hospital, Heinrich Heine University, Düsseldorf, Germany.; Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich-Heine University, Düsseldorf, Germany.; German Center for Diabetes Research, Partner Düsseldorf, Düsseldorf, Germany.; University College London Institute for Liver and Digestive Health, Royal Free Hospital, London, United Kingdom.; Sheila Sherlock Liver Centre, Royal Free Hospital, London, United Kingdom.; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong.; Center for Liver Diseases, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, VA, United States.; University of Haifa, Faculty of Social Welfare and Health Sciences, School of Public Health, Mount Carmel, Haifa, Israel.; Department of Gastroenterology, Tel-Aviv Medical Centre, Tel-Aviv, Israel.; UCM Digestive Diseases, CIBEREHD and IBIS, Virgen del Rocío University Hospital, University of Seville, Seville, Spain. [email protected].; Metabolic Liver Research Program, I. Department of Medicine, University Medical Centre Mainz, Mainz, Germany. [email protected].

DOI: 10.1038/s41575-021-00477-7

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MeSH Terms: Critical Pathways, Delivery of Health Care, Dietetics, Disease Management, Gastroenterology, Humans, Non-alcoholic Fatty Liver Disease, Nursing, Patient Care Team, Physical Therapy Specialty, Policy Making, Practice Guidelines as Topic, Primary Health Care