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Abstract Details
The paradigm shift from NAFLD to MAFLD: A global primary care viewpoint
Liver Int. 2022 Feb 7. doi: 10.1111/liv.15188. Online ahead of print.
Taghreed M Farahat1, Mehmet Ungan2, Josep Vilaseca3, Jacqueline Ponzo4, Pramendra Prasad Gupta5, Andrew D Schreiner6, Wadeia Al Sharief7, Kelly Casler8, Tafat Abdelkader9, Ludovico Abenavoli10, Fatima-Zohra Mchich Alami11, Mattias Ekstedt12, Muntadar Saad Jabir13, Matthew J Armstrong14, Mona Osman El Hage15, Johannes Wiegand16, Dina Attia17, Veronique Verhoeven18, Ashraf Abdul Qayoum Amir19, Nagwa Nashat1, Emmanuel A Tsochatzis20, Yasser Fouad21, Helena Cortez-Pinto22
Author information
1The Egyptian Family Medicine Association (EFMA), WONCA East Mediterranean, Menoufia University, Department of Public Health and Community Medicine, Menoufia, Egypt.
2The Turkish Association of Family Physicians (TAHUD), WONCA Europe, Department of Family Medicine, Ankara University School of Medicine, Ankara, Turkey.
3Barcelona Esquerra Primary Health Care Consortium, Barcelona, Spain; WONCA Europe; Faculty of Medicine, University of Barcelona, Barcelona, Spain; Faculty of Medicine, University of Vic - Central University of Catalonia, Vic, Barcelona, Spain.
4WONCA Iberoamericana, Facultad de Medicina, Universidad de la República. Av. General Flores 2125. 11.800 Montevideo Departamento de Montevideo, Uruguay.
5WONCA South Asia, Department of General Practice and Emergency Medicine, Koirala Institute of Health Sciences, B.P, Dharan, Nepal.
6Departments of Medicine Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.
7President Emirates Family Medicine Society, President Family Medicine Scientific Council in Arab Board for Medical Specialization Council, Director Medical Education & Research Department, Dubai, UAE.
8Director of Family Nurse Practitioner Program, The Ohio State University College of Nursing, Columbus, Ohio, USA.
9President of the Algerian Society of General Medicine / Societe Algerienne De Medecine Generale (SAMG), Algeria.
10Department of Health Sciences, Magna Graecia University, Catanzaro, Italy.
11President of the National Collective of General Practitioners of Marocco (MG Maroc), Rabat Morocco.
12Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
13President of the Iraqi Family Physicians Society, Baghdad, Iraq.
14Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.
15Department of Family Medicine, American University of Beirut Medical Center, Lebanon.
16Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Liebigstrasse 20, 04103, Leipzig, Germany.
17Department of Gastroenterology, Hepatology and Endemic Medicine, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt.
18Department of FAMPOP (Family Medicine and Population Health), University of Antwerp, Antwerpen, Belgium.
19International Medical Center hospital- Jeddah, Saudi Arabia.
20UCL Institute for Liver and Digestive Health, Royal Free Hospital and UCL, London, UK.
21Department of Gastroenterology, Hepatology and Endemic Medicine, Faculty of Medicine, Minia University, Egypt.
22Clínica Universitária de Gastrenterologia, Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
Abstract
In 2020, a group of international experts reached a consensus to comprehensively revisit the current definition of fatty liver disease. In clinical settings, most of the patients with fatty liver disease are first identified and subsequently followed up in the community by primary care practitioners (PCPs). Therefore, it is crucial to understand PCPs perspectives regarding the proposed redefinition of fatty liver disease as well as the implications on primary care of patients. Thus, the aim of this paper is for an international team of experts in primary care to provide perspective regarding the proposed redefinition of metabolic-dysfunction associated fatty liver disease (MAFLD). Currently, numerous systemic barriers exist for PCPs who are managing fatty liver disease. These include the diagnosis and screening, efficient referral pathway, restrictive policies, disease awareness and continuum of care. The revolutionary simplification in diagnosis and evaluation that the MAFLD definition is providing, we believe can help to overcome some of these barriers and may facilitate the implementation of effective fatty liver disease management, prevent overdiagnosis and overtreatment in secondary and tertiary care but also reduce underdiagnosis in primary care by PCPs by promoting widespread active case findings of MAFLD and reaching to a balance on behalf of public health.