Lipids & metabolic liver disease
Safety-Net Primary Care and Endocrinology Clinicians’ Knowledge and Perspectives on Screening for Nonalcoholic Fatty Liver Disease: A Mixed-Methods Evaluation
Authors' conclusion
Knowledge gaps may hamper uptake of new guidelines for NAFLD screening in primary care and endocrinology clinics in an urban safety-net health care system. Implementation strategies focused on training and educating clinicians and informed by behavioral economics may increase screening.
Study context
- Population
- Primary care, primary care subspecialty and endocrinology clinicians in an urban safety-net health care system13 interviewed
- Participants
- 109 participants
- Outcome
- NAFLD knowledge and screening practice
Methodological detailssequential explanatory, survey and qualitative interviews
- Sequential explanatory
- Survey and qualitative interviews
Main finding
As reported in the abstract
- Underestimated or did not know nonalcoholic fatty liver disease (NAFLD) prevalence
- 68%
- Did not use recommended noninvasive tests for risk stratification
- 65%
- Comfortable with screening for NAFLD
- 27%
- Comfortable with managing NAFLD
- 17%
- Survey response rate
- 36.5%
Observational data: associations, not effects.
Further findings
Endocrinologists vs other clinicians
- Endocrinologists had greater knowledge of risk factors but lower comfort and more often felt screening was not their responsibility
Qualitative themes
- Lack of knowledge about screening; concern for underdiagnosing NAFLD; perceived severity impacts screening beliefs; screening should occur in primary care but is not normative; concerns about benefit; competing demands with a complex population; need for easier ways to integrate screening
Original publication
Safety-Net Primary Care and Endocrinology Clinicians’ Knowledge and Perspectives on Screening for Nonalcoholic Fatty Liver Disease: A Mixed-Methods Evaluation. Endocr Pract. Published 5 January 2024. doi:10.
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