Living in the non‐alcoholic fatty liver disease silent epidemic: a qualitative systematic review of patients' perspectives

Abstract

Summary Background Non‐alcoholic fatty liver disease (NAFLD) affects one‐fourth of the global population. Yet, the care of these patients is limited and awareness of NAFLD remains low in the general public. Investigations into the lives of these patients are often forgotten and traditional quantitative studies only paint part of the picture. Aim To assess the first‐hand accounts of these individuals and their perspective on living with NAFLD. Methods A systematic search was conducted on Medline, Embase, CINAHL, PsycINFO and Web of Science database for qualitative literature regarding patients' perspectives on NAFLD. An inductive thematic analysis was conducted to generate themes and supportive subthemes. Results We incuded eight articles in the review. There were three major themes including the impact on the quality of life, knowledge and information, and attitudes and perceptions on care. The impact of the quality of life details the emotional and physical distress of NAFLD. Knowledge and information include the lack of sufficient communication between healthcare providers and patients with a distinct knowledge gap. Attitudes and perceptions on care extrapolate the current active participation of patients and needs of the patients and the future care that they desire. Conclusion This review synthesises first‐hand accounts of individuals with NAFLD. With the growing burden of NAFLD, future public interventions must consider individual views for success to be found. The identified themes serve as a forefront for consideration for public policies. Ultimately, NAFLD is a multisystem disease, which must be managed by a multidisciplinary team.

Screening strategy for non-alcoholic fatty liver disease

“…This is a social and behavioral challenge, as screening is a personal choice that is ideally based on informed decision-making. Increased patient participation [ 139 ] and physician awareness of the importance of screening will be crucial in reducing the morbidity and mortality related to NAFLD.…”

Impairment of patient‐reported outcomes among patients with non‐alcoholic fatty liver disease: a registry‐based study

“…[11][12][13] In light of the current therapeutic vacuum concerning disease-modifying treatments, recent years have witnessed an increased focus on measures of how patients with NAFLD feel, function and survive. [14][15][16] In this context, patientreported outcomes (PROs) represent an umbrella definition describing patients' subjective perception of the impact of their disease without interpretation from a clinician or anyone else. 17,18 The PROs range from health-related quality of life (HRQL; defined as the impact of NAFLD on different dimensions of patients' daily life) to fatigue and impairment in work productivity.…”

“…Several phase 3 clinical trials are currently ongoing but, at present, there are no approved specific treatments for NAFLD 11–13 . In light of the current therapeutic vacuum concerning disease‐modifying treatments, recent years have witnessed an increased focus on measures of how patients with NAFLD feel, function and survive 14–16 . In this context, patient‐reported outcomes (PROs) represent an umbrella definition describing patients' subjective perception of the impact of their disease without interpretation from a clinician or anyone else 17,18 .…”

Placebo Adverse Events in Non-alcoholic Steatohepatitis Clinical Trials: A Pooled Analysis of 2,944 Participants

“…Non-alcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease affecting one quarter of the global population and represents a spectrum of non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH) (1)(2)(3)(4)(5). An estimated 20% of NAFL will progress to NASH (3,6) and the latter is characterized by the presence of lobular inflammation, hepatocellular ballooning with or without fibrosis.…”