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Abstract Details
Defining comprehensive models of care for NAFLD
Nat Rev Gastroenterol Hepatol. 2021 Jun 25. doi: 10.1038/s41575-021-00477-7.Online ahead of print.
Jeffrey V Lazarus12, Quentin M Anstee34, Hannes Hagström5, Kenneth Cusi6, Helena Cortez-Pinto7, Henry E Mark8, Michael Roden91011, Emmanuel A Tsochatzis1213, Vincent Wai-Sun Wong14, Zobair M Younossi15, Shira Zelber-Sagi1617, Manuel Romero-Gómez#18, Jörn M Schattenberg#19
Author information
1Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain. jeffrey.lazarus@isglobal.org.
2EASL International Liver Foundation, Geneva, Switzerland. jeffrey.lazarus@isglobal.org.
3Translational & Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom.
4The Liver Unit & NIHR Biomedical Research Centre, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom.
5Karolinska Institute, Stockholm, Sweden.
6Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, Veterans Health Administration and University of Florida, Gainesville, FL, United States.
7Clínica Universitária de Gastrenterologia, Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
8EASL International Liver Foundation, Geneva, Switzerland.
9Department of Endocrinology and Diabetology, Medical Faculty and University Hospital, Heinrich Heine University, Düsseldorf, Germany.
10Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich-Heine University, Düsseldorf, Germany.
11German Center for Diabetes Research, Partner Düsseldorf, Düsseldorf, Germany.
12University College London Institute for Liver and Digestive Health, Royal Free Hospital, London, United Kingdom.
13Sheila Sherlock Liver Centre, Royal Free Hospital, London, United Kingdom.
14Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
15Center for Liver Diseases, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, VA, United States.
16University of Haifa, Faculty of Social Welfare and Health Sciences, School of Public Health, Mount Carmel, Haifa, Israel.
17Department of Gastroenterology, Tel-Aviv Medical Centre, Tel-Aviv, Israel.
18UCM Digestive Diseases, CIBEREHD and IBIS, Virgen del Rocío University Hospital, University of Seville, Seville, Spain. mromerogomez@us.es.
19Metabolic Liver Research Program, I. Department of Medicine, University Medical Centre Mainz, Mainz, Germany. joern.schattenberg@unimedizin-mainz.de.
#Contributed equally.
Abstract
Non-alcoholic fatty liver disease (NAFLD) is now the leading cause of chronic liver disease globally. Despite the increased demand placed on health-care systems, little attention has been given to the design and implementation of efficient and effective models of care for patients with NAFLD. In many health-care settings, no formal pathways exist and, where pathways are in place, they are often not standardized according to good practices. We systematically searched the peer-reviewed literature with the aim of identifying published examples of comprehensive models of care that answered four key questions: what services are provided? Where are they provided? Who is offering them? How are they coordinated and integrated within health-care systems? We identified seven models of care and synthesized the findings into eight recommendations nested within the 'what, where, who and how' of care models. These recommendations, aimed at policy-makers and practitioners designing and implementing models of care, can help to address the increasing need for the provision of good practice care for patients with NAFLD.