Non-alcoholic fatty liver disease (NAFLD) study
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Non-alcoholic fatty liver disease (NAFLD) – a condition in which fat accumulates in the liver in people who drink little or no alcohol – is the most common type of chronic liver disease in Australia. NAFLD is associated with a reduction in health-related quality of life, and as the number of NAFLD cases increase, the health system will incur increased costs associated with its diagnosis and management. Currently, many patients who present to primary care with abnormal liver function tests or steatosis on liver ultrasound are referred for assessment in secondary care. Due to the large number of patients with NAFLD, this results in long waiting times for clinical and fibrosis assessment and places unnecessary burden on the public hospital system.
The LOCATE-NAFLD study (LOCal Assessment and Triage Evaluation of Non-Alcoholic Fatty Liver Disease) is being led by researchers from the Australian Centre for Health Services Innovation at the Queensland University of Technology, in collaboration with leading liver disease experts and researchers from the University of the Sunshine Coast, the University of Queensland and QIMR Berghofer. It is funded by the Medical Research Future Fund Keeping Australians Out of Hospital initiative (GNT1175567), and is running from 2019-2022 in the Metro South HHS and Sunshine Coast HHS regions in Queensland.
LOCATE-NAFLD aims to reduce this burden on the hospital system. It is a randomised controlled trial, comparing two models of care: usual care (waiting to be seen at a specialist hepatology clinic) versus the LOCATE-NAFLD intervention. Eligible patients who are referred to the Logan Hospital and Sunshine Coast University Hospital hepatology clinics are being invited to participate. Once enrolled, participants randomised to the intervention will be given an appointment to receive a non-invasive Fibroscan in a community clinic. This earlier review and diagnosis allows more prompt review of high-risk patients, who will be seen sooner by a specialist, and for low-risk patients to be returned to the care of their GP for management, reducing unnecessary hospital appointments.
Through this faster assessment and more accurate triaging of patients in the community, the study aims to reduce referrals for hospital-based appointments, and improve the surveillance of high-risk disease, resulting in enhanced management of complications that can result in avoidable, high-cost hospital admissions.
In addition to the impacts this study may have on patient’s health, researchers are also interested in the impact this new pathway may have on patient quality of life and GP’s knowledge of NAFLD management, and the potential cost-savings to the broader health system.