Nonalcoholic Fatty Liver Disease: Interface Between Primary Care and Hepatology Clinics

摘要: Primary care physicians (PCPs) have the primary role in diagnosis and management of nonalcoholic fatty liver disease (NAFLD), selecting patients for referral to a hepatologist further evaluation. This study aimed characterize PCP referrals diagnosed with NAFLD at major hospital, determine severity patient pathway following evaluation secondary care. New seen hepatology outpatient clinic (HOC) were identified from HOC scheduling database. these retrieved electronic medical records reviewed by clinicians, along hepatologists' notes letters. Over 14-month period, 234 new received NAFLD, accounting 20.4% total number cases (n = 1,147) HOC. The 170 individual PCPs 135 practices. Most (88.5%) referred investigation abnormal enzymes or other clinical concerns, including iron studies, hepatomegaly, abdominal pain. Only 27 (11.5%) included an assessment severity. Following clinic, 175 (74.8%) found low risk advanced fibrosis, most 159; 90.9%) discharged back their ongoing follow-up Conclusion: In addition better access noninvasive fibrosis tests, educational strategies enhance awareness recognition as cause many initial concerns prompting might improve stratification increase appropriateness referrals.