[Survey on knowledge of metabolic liver disease (EHMet) among Primary Care Physicians in Spain]

Improving the management of metabolic dysfunction-associated steatotic liver disease (MASLD) in Primary Care requires a good knowledge of the disease. This study evaluated the knowledge of biomarkers and comorbidities associated with the disease among Primary Care Physicians (PCPs), the resources available for diagnosis, and the relationship with hepatologists.

Cross-sectional study based on an anonymous email survey sent to PCPs actively practicing at the time of distribution. Retired professionals were excluded. The survey comprised 29 questions grouped into 3sections: 1. Sociodemographic characteristics, 2. Relationship with the gastroenterology department, 3. Diagnosis and management of MAFLD.

A total of 362 responses were received (10.23% participation). Of the respondents, 64.2% were women, and the most participative age group was 50-59 (29.4%). Cantabria, Catalonia, Andalusia, Castilla-León and Madrid were the regions with the highest response rates. 81.5% of PCPs did not have protocols for diagnosis and management, and while two-thirds were familiar with the Fib-4 marker, only half used it. Having protocols increased the use of Fib-4 (OR 4.41; 95%CI 1.68-11.53). A total of 81.5% recognized the importance of extrahepatic comorbidities, and 92% actively screened for cardiovascular risk factors. Elastography was considered useful by 58.7%, but only 11% had access to it. 72% of PCPs had no relationship with specialists, although 60% had access to a Hepatology Unit.

It is necessary to improve knowledge of MAFLD, strengthen collaboration between care levels, and establish standardized management protocols.