Awareness of nonalcoholic steatohepatitis and associated practice patterns of primary care physicians and specialists.
Awareness of nonalcoholic steatohepatitis and associated practice patterns of primary care physicians and specialists.
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DOI：
10.1186/s13104-016-1946-1
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发表时间：
2016-03-11
影响因子：
1.8
通讯作者：
Caze, Alexis
中科院分区：
文献类型：
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作者：
Polanco-Briceno, Susan;Glass, Daniel;Caze, Alexis
背景：代谢综合征的肝脏表现为非酒精性脂肪肝。非酒精性脂肪性肝炎（非酒精性脂肪性肝病的进展形式）患者发生纤维化、肝硬化和终末期肝病的风险增加。在美国，非酒精性脂肪性肝病的患病率估计为20-30%，非酒精性脂肪性肝炎的患病率估计为2-5%;然而，医生对这些疾病的认识有限。本研究的目的是确定目前医生在诊断和管理非酒精性脂肪性肝病和非酒精性脂肪性肝炎方面的意识和实践水平。方法：医生被要求参加一个在线的35个问题的调查，了解他们对各种肝脏疾病和当前实践的认识。结果：在302名回应医生中，152名是初级保健医生，150名是专家（包括胃肠病学家和肝病学家）。与初级保健医生相比，更多的专家报告说，他们知道非酒精性脂肪性肝病和非酒精性脂肪性肝炎之间的差异（p < 0.001），他们定期筛查非酒精性脂肪性肝病（p < 0.001）和非酒精性脂肪性肝炎（p < 0.001）。几乎一半的回应初级保健医生报告不熟悉非酒精性脂肪肝疾病和非酒精性脂肪性肝炎的差异，即使他们知道两者，但58%的初级保健医生正在治疗非酒精性脂肪肝疾病和/或非酒精性脂肪性肝炎患者。此外，那些报告不熟悉非酒精性脂肪性肝炎的初级保健医生平均治疗3.7例患者，并报告与熟悉的初级保健医生一样可能治疗新的非酒精性脂肪性肝炎患者。超过一半的专家使用非侵入性诊断测试，以确认非酒精性脂肪性肝炎，和10%的专家报告治疗患者的药物不建议由当前guidelines.CONCLUSIONS：尽管报告说，他们不熟悉非酒精性脂肪性肝炎，初级保健医生报告说，他们可能会继续诊断和管理非酒精性脂肪性肝炎患者;因此，需要对医生进行更多关于非酒精性脂肪性肝病和非酒精性脂肪性肝炎最新实践指南的教育。
BACKGROUND: The hepatic manifestation of metabolic syndrome is nonalcoholic fatty liver disease. Patients with nonalcoholic steatohepatitis, the progressive form of nonalcoholic fatty liver disease, have increased risk of fibrosis, cirrhosis and end-stage liver disease. Estimates of prevalence in the United States range from 20-30% for nonalcoholic fatty liver disease and 2-5% for nonalcoholic steatohepatitis; however, physician awareness of these diseases is limited. The purpose of this study was to determine the current level of physician awareness and practices in the diagnosis and management of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis within the United States.METHODS: Physicians were asked to participate in an online, 35-question survey about their awareness of various liver conditions and current practices.RESULTS: Of the 302 responding physicians, 152 were primary care physicians, and 150 were specialists (comprised of gastroenterologists and hepatologists). More specialists than primary care physicians reported that they were aware of the differences between nonalcoholic fatty liver disease and nonalcoholic steatohepatitis (p < 0.001) and that they routinely screened for nonalcoholic fatty liver disease (p < 0.001) and nonalcoholic steatohepatitis (p < 0.001). Almost half of the responding primary care physicians reported being unfamiliar with the nonalcoholic fatty liver disease and nonalcoholic steatohepatitis differences even though they were aware of both, yet 58% of those primary care physicians were treating patients with nonalcoholic fatty liver disease and/or nonalcoholic steatohepatitis. In addition, those primary care physicians who reported being unfamiliar with nonalcoholic steatohepatitis were treating an average of 3.7 patients and reported being as likely as familiar primary care physicians to treat new patients with nonalcoholic steatohepatitis. More than half of the specialists used noninvasive diagnostic test to confirm nonalcoholic steatohepatitis, and 10% of the specialists reported treating patients with drugs not recommended by the current guidelines.CONCLUSIONS: Despite reporting they were not familiar with nonalcoholic steatohepatitis, primary care physicians reported they would likely continue to diagnose and manage patients with nonalcoholic steatohepatitis; therefore, more physician education on the recent practice guideline for nonalcoholic fatty liver disease and nonalcoholic steatohepatitis is needed.