Liver disease management as routine work in primary care: a qualitative interview study to guide implementation

Area of Science:

• Hepatology
• Primary Care Medicine
• Implementation Science

Background:

• Rising liver disease morbidity in the UK, primarily from alcohol and non-alcoholic fatty liver disease (NAFLD).
• Early detection and treatment are crucial for managing liver disease.
• Existing liver disease pathways are not integrated into routine primary care.

Purpose of the Study:

• To explore primary care healthcare professional (HCP) understanding of chronic liver disease.
• To identify how chronic liver disease management can be integrated into long-term condition management within primary care.

Main Methods:

• Qualitative interview study with 20 primary care HCPs in Northern England.
• Semi-structured interviews guided by Normalisation Process Theory (NPT).
• Thematic analysis of concurrent data collection and analysis.

Main Results:

• Need for incentivised frameworks and protocols to improve understanding and practice.
• Inclusion of liver diseases in multimorbidity care to simplify workload.
• Definition of the GP role in lifestyle-focused treatment pathways and the importance of education and local champions.

Conclusions:

• Awareness of implementation challenges is vital for embedding chronic liver disease management in primary care.
• Findings can guide the adoption of effective liver disease pathways.
• Bridging the implementation gap is essential for improving patient outcomes.