Unmasking a Stealth Killer: The Need for Increased Awareness of NASH

Sherif, Zaki A.

doi:10.1007/s10620-019-05832-y

Cited by 3 publications

(8 citation statements)

References 11 publications

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“…Given the critical role providers must play in increasing public awareness and promoting effective NAFLD self-management (Sherif, 2020), this article offers important lessons for informing educational efforts designed to promote culturally sensitive risk and disease management communication approaches. Our data indicate that service provision should be informed by how the pathological intricacies of NAFLD interact with the cultural and structural factors facing Mexicans immigrants to produce significant emotional responses in form of surprise, fear, and hope that have the potential to motivate positive action toward risk reduction.…”

Section: Discussionmentioning

confidence: 99%

How Mexicans’ Emotional Responses to Non-Alcoholic Fatty Liver Disease Can Help Inform Culturally Congruent Health Care

et al. 2022

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Introduction: This article aims to increase understanding of how Mexican immigrants respond to learning about non-alcoholic fatty liver disease (NAFLD), a spectrum disease with a heavy burden among Mexican-origin people. Methodology: This article presents findings from qualitative interviews ( n = 26) that formed part of a mixed-methods study of foreign-born Mexican immigrants carried out in 2019 to 2020 in southern Arizona to assess NAFLD awareness. Results: We documented common experiences of surprise, fear, and hope during study participation, all of which motivated research participants to reduce their NAFLD risk by seeking additional information, sharing it with others, and making lifestyle changes. Discussion: Understanding how these emotional experiences are tied to cultural and historical factors—including Mexico’s high rates of liver disease, participant’s limited access to health care, and the ability to address the NAFLD risk with lifestyle changes—may promote the development of more effective and culturally congruent care in this population.

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Section: Discussionmentioning

confidence: 99%

How Mexicans’ Emotional Responses to Non-Alcoholic Fatty Liver Disease Can Help Inform Culturally Congruent Health Care

et al. 2022

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“…2 A recent study of patients with a BMI >25 kg/m 2 and elevated alanine transaminase (ALT) in the United States (US) showed that 95% of those affected by MASLD were unaware of their condition. 2 Lack of awareness of MASLD amongst the general population, and even clinicians and public health officials, is of equal concern in countries like Germany, Italy and the United Kingdom (UK), where the incidence of MASLD is expected to grow. 3,4 The timely identification and management of NAFLD is crucial, as this condition can progress into more serious diseases, including metabolic dysfunction-associated steatohepatitis (MASH), advanced fibrosis and hepatocellular carcinoma (HCC).…”

Section: Introductionmentioning

confidence: 99%

“…3,4 The timely identification and management of NAFLD is crucial, as this condition can progress into more serious diseases, including metabolic dysfunction-associated steatohepatitis (MASH), advanced fibrosis and hepatocellular carcinoma (HCC). 2 Although liver biopsies are still considered the standard for a conclusive diagnosis of NASH, and the assessment of advanced fibrosis, they are used selectively due to their invasive nature. Risk stratification, beginning with the application of non-invasive tests (NITs) by primary care physicians, can enhance the quality of health care delivered to patients 5 and will substantially increase correct referral to secondary care, as shown in a randomized trial.…”

Section: Introductionmentioning

confidence: 99%

Use of non‐invasive diagnostic tools for metabolic dysfunction‐associated steatohepatitis: A qualitative exploration of challenges and barriers

Tsochatzis,

Valenti,

Thiele

et al. 2024

Liver International

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Background and AimsNon‐invasive tests (NITs) are underutilized for diagnosis and risk stratification in metabolic dysfunction‐associated steatotic liver disease (MASLD), despite good accuracy. This study aimed to identify challenges and barriers to the use of NITs in clinical practice.MethodsWe conducted a qualitative exploratory study in Germany, Italy, United Kingdom and United States. Phase 1 participants (primary care physicians, hepatologists, diabetologists, researchers, healthcare administrators, payers and patient advocates; n = 29) were interviewed. Phase 2 participants (experts in MASLD; n = 8) took part in a group discussion to validate and expand on Phase 1 findings. Finally, we triangulated perspectives in a hybrid deductive/inductive thematic analysis.ResultsFour themes hindering the use of NITs emerged: (1) limited knowledge and awareness; (2) unclear referral pathways for patients affected by liver conditions; (3) uncertainty over the value of NITs in monitoring and managing liver diseases; and (4) challenges justifying system‐level reimbursement. Through these themes, participants perceived a stigma associated with liver diseases, and primary care physicians generally lacked awareness, adequate knowledge and skills to use recommended NITs. We identified uncertainties over the results of NITs, specifically to guide lifestyle intervention or to identify patients that should be referred to a specialist. Participants indicated an ongoing need for research and development to improve the prognostic value of NITs and communicating their cost‐effectiveness to payers.ConclusionsThis qualitative study suggests that use of NITs for MASLD is limited due to several individual and system‐level barriers. Multi‐level interventions are likely required to address these barriers.

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“…11 Despite the prevalence and public health burden of NAFLD and NASH, awareness of the conditions among public and healthcare providers (HCP) remains limited and practice challenges related to the condition persist. 12,13 There remains a lack of approved therapeutic agents while the incidence of NASH is increasing globally. Development of pharmacological treatments has been hindered by slow disease progression, lack of easily measurable surrogate endpoints, and the variable placebo response, given the effect of lifestyle modification and other non-pharmacological therapies in clinical trials.…”

Section: Introductionmentioning

confidence: 99%

“…Despite the prevalence and public health burden of NAFLD and NASH, awareness of the conditions among public and healthcare providers (HCP) remains limited and practice challenges related to the condition persist 12,13 . There remains a lack of approved therapeutic agents while the incidence of NASH is increasing globally.…”

Section: Introductionmentioning

confidence: 99%

Clinical practice gaps and challenges in non‐alcoholic steatohepatitis care: An international physician needs assessment

Lazure

Tomlinson

Kowdley

et al. 2022

Liver International

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Background and aims: Even as several pharmacological treatments for non-alcoholic steatohepatitis (NASH) are in development, the incidence of NASH is increasing on an international scale. We aim to assess clinical practice gaps and challenges of hepatologists and endocrinologists when managing patients with NASH in four countries (Germany/Italy/United Kingdom/United States) to inform educational interventions.Methods: A sequential mixed-method design was used: qualitative semi-structured interviews followed by quantitative online surveys. Participants were hepatologists and endocrinologists practising in one of the targeted countries. Interview data underwent thematic analysis and survey data were analysed with chi-square and Kruskal-Wallis tests.Results: Most interviewees (n = 24) and surveyed participants (89% of n = 224) agreed that primary care must be involved in screening for NASH, yet many faced challenges involving and collaborating with them. Endocrinologists reported low knowledge of which blood markers to use when suspecting NASH (56%), when to order an MRI (65%) or ultrasound/FibroScan® (46%), and reported sub-optimal skills interpreting alanine aminotransferase (ALT, 37%) and aspartate aminotransferase (AST, 38%) blood marker test results, causing difficulty during diagnosis. Participants believed that more evidence is needed for upcoming therapeutic agents; yet, they reported sub-optimal knowledge of eligibility criteria for clinical trials. Knowledge and skill gaps when managing comorbidities, as well as skill gaps facilitating patient lifestyle changes were reported. Conclusions: Educational interventions are needed to address the knowledge and skill gaps identified and to develop strategies to optimize patient care, which include implementing relevant care pathways, encouraging referrals and testing, and | 1773 LAZURE et aL.

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Unmasking a Stealth Killer: The Need for Increased Awareness of NASH

Abstract: Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Cited by 3 publications

References 11 publications

How Mexicans’ Emotional Responses to Non-Alcoholic Fatty Liver Disease Can Help Inform Culturally Congruent Health Care

How Mexicans’ Emotional Responses to Non-Alcoholic Fatty Liver Disease Can Help Inform Culturally Congruent Health Care

Use of non‐invasive diagnostic tools for metabolic dysfunction‐associated steatohepatitis: A qualitative exploration of challenges and barriers

Clinical practice gaps and challenges in non‐alcoholic steatohepatitis care: An international physician needs assessment

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