一个澳大利亚社区基础的代谢功能障碍相关的肥胖性肝病护理途径为2型糖尿病患者:障碍和考虑
Lucy Gracen1, Melanie Aikebuse2,3, Babak Sarraf2,3,4
1Department of Gastroenterology and Hepatology, Royal Brisbane and Women's Hospital, Herston, QLD, Australia.
Patient preference and adherence
|September 16, 2024
概括
在2型糖尿病 (T2D) 患者中实施代谢功能障碍相关的脂肪性肝病 (MASLD) 查面临低参与率和转诊率. 需要进一步的研究来改善对肝脏健康评估的参与.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 内分泌学 在内分泌学.
- 公共卫生 公共卫生
背景情况:
- 临床指南建议在2型糖尿病 (T2D) 患者中对代谢功能障碍相关的脂肪性肝病 (MASLD) 进行高级纤维化查.
- 在社区环境中实施MASLD查的实际可行性,障碍和考虑因素在很大程度上仍未得到审查.
研究的目的:
- 评估可行性,并确定为T2D患者实施社区性肝脏健康检查计划的障碍.
- 评估转诊过程和GP与MASLD查结果的接触.
主要方法:
- 一项前性研究,涉及到参加社区诊所的T2D成年人和那些由全科医生转介或自我转介的人.
- 使用FibroScan对302名参与者进行肝硬化和肝硬度的临床评估.
- 为全科医生提供"模板"信件,详细说明结果,解释和管理建议.
主要成果:
- 共有638人被邀请,其中302人接受了FibroScan评估.
- 62名参与者 (20.5%) 根据纤维化风险或"红旗"建议转诊到第三级肝脏诊所.
- 只有27个 (44%) 的建议转介由全科医生完成,90%的全科医生对模板信的评价是乐观的.
结论:
- 在肝脏健康检查和随后的转诊中参与率低,突出显示了MASLD认可和参与方面的挑战.
- 社会对肝纤维化死亡风险的认可不足,健康优先事项的竞争以及对肝纤维化死亡风险的低估可能导致吸收率低.
- 需要进行进一步的研究,以制定加强参与和评估对肝脏相关发病率和死亡率的影响的策略.
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