A cross-sectional study of the public health response to non-alcoholic fatty liver disease in Europe
A cross-sectional study of the public health response to non-alcoholic fatty liver disease in Europe
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DOI：
10.1016/j.jhep.2019.08.027
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发表时间：
2020-01-01
影响因子：
25.7
通讯作者：
Dufour, Jean-Francois
中科院分区：
文献类型：
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作者：
Lazarus, Jeffrey, V;Ekstedt, Mattias;Dufour, Jean-Francois
背景和目标：非酒精性脂肪性肝病（NAFLD）是全球范围内日益严重的公共卫生问题，已成为生物医学研究的重要领域。我们的目的是确定欧洲国家是否对NAFLD和非酒精性脂肪性肝炎（NASH）采取了充分的公共卫生应对措施：方法：2018年和2019年，29个欧洲国家的NAFLD专家完成了一项关于其国家政策，指南，意识，监测，诊断和临床评估的英语调查。数据进行了汇编，质量检查，对现有的官方文件和reportedictively. Results：没有29个参与国家的书面战略或行动计划NAFLD。两个国家（7%）在相关的现有策略（肥胖和酒精）中提到了NAFLD或NASH。10个（34%）报告有专门针对NAFLD的国家临床指南，并且在诊断后，所有指南都包括评估糖尿病和肝硬化的建议。11个国家（38%）建议对所有糖尿病、肥胖和/或代谢综合征患者进行NAFLD筛查。五个国家（17%）在初级保健中有随访和专家转诊的转诊算法，7个国家（24%）报告了针对NAFLD的结构化生活方式计划。7人（24%）资助了特别包括预防肝病的宣传活动。四个国家（14%）报告有民间社会团体，解决NAFLD和3个国家（10%）有国家登记处，包括NAFLD. Conclusions：我们发现，一个全面的公共卫生应对NAFLD是缺乏在调查的欧洲国家。这包括以战略形式的政策，临床指南，宣传活动，民间社会参与和卫生系统组织，包括registrations.Lay总结：我们与欧洲国家的专家进行了一项关于非酒精性脂肪肝的调查，加上从政策，临床指南，意识和监测的官方文件中提取的数据。我们发现，普遍缺乏国家政策、宣传运动和民间社会的参与，流行病登记册也很少。(C)2019年欧洲肝脏研究协会。由爱思唯尔公司出版
Background & Aims: Non-alcoholic fatty liver disease (NAFLD) is a growing public health problem worldwide and has become an important field of biomedical inquiry. We aimed to determine whether European countries have mounted an adequate public health response to NAFLD and non-alcoholic steatohepatitis (NASH).Methods: In 2018 and 2019, NAFLD experts in 29 European countries completed an English-language survey on policies, guidelines, awareness, monitoring, diagnosis and clinical assessment in their country. The data were compiled, quality checked against existing official documents and reported descriptively.Results: None of the 29 participating countries had written strategies or action plans for NAFLD. Two countries (7%) had mentions of NAFLD or NASH in related existing strategies (obesity and alcohol). Ten (34%) reported having national clinical guidelines specifically addressing NAFLD and, upon diagnosis, all included recommendations for the assessment of diabetes and liver cirrhosis. Eleven countries (38%) recommended screening for NAFLD in all patients with either diabetes, obesity and/or metabolic syndrome. Five countries (17%) had referral algorithms for follow-up and specialist referral in primary care, and 7 (24%) reported structured lifestyle programmes aimed at NAFLD. Seven (24%) had funded awareness campaigns that specifically included prevention of liver disease. Four countries (14%) reported having civil society groups which address NAFLD and 3 countries (10%) had national registries that include NAFLD.Conclusions: We found that a comprehensive public health response to NAFLD is lacking in the surveyed European countries. This includes policy in the form of a strategy, clinical guidelines, awareness campaigns, civil society involvement, and health systems organisation, including registries.Lay summary: We conducted a survey on non-alcoholic fatty liver disease with experts in European countries, coupled with data extracted from official documents on policies, clinical guidelines, awareness, and monitoring. We found a general lack of national policies, awareness campaigns and civil society involvement, and few epidemiological registries. (C) 2019 European Association for the Study of the Liver. Published by Elsevier B.V.