Readiness for the epidemic: The adult nonalcoholic fatty liver disease toolkit for primary care nurse practitioners

Abstract

Background and purpose: Nonalcoholic fatty liver disease (NAFLD) prevalence has reached epidemic proportions, and the severe form, nonalcoholic steatohepatitis, can result in cirrhosis and liver failure. The growing prevalence requires primary care (PC) providers to be adept at recognition and management; however, they experience significant knowledge gaps that can result in delayed access to interventions that could improve outcomes. This study's aim was to develop and evaluate a toolkit to improve knowledge gaps and support evidence-based practice (EBP) among PC nurse practitioners caring for patients with NAFLD in a midwestern state. Methods and intervention: The Adult NAFLD Toolkit was designed using the Knowledge to Action framework and guidelines from the Agency for Healthcare Research and Quality. The success of the toolkit was evaluated by administering the NAFLD survey for general practitioners in a pre–post evaluation design. Results: Pre–post survey scores (N = 11) were compared for statistically significant change using the Wilcoxon signed rank test for matched pairs and showed improvement in overall knowledge (p = .011), perceived preparedness to care for NAFLD (p = .007), intention to recommend weight loss for management (p = .008), and intention to use the NAFLD fibrosis score for patient monitoring (p = .008). Conclusions: The results of this pilot study demonstrate successful implementation and positive outcomes of an EBP toolkit and support its expanded use. Continued evaluation on a larger scale is needed. Health care providers can use the process described in this article to develop and implement toolkits to support EBP of other PC issues.

Tailored Model of Care for Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease

“…Additionally, this highlights the need for further education and training for PCP on disease diagnosis and management. 108 Education is also critical in addressing the gaps in MASLD identification and management in primary care. It is essential to ensure that PCP know the latest clinical practice guidelines and are equipped with the necessary skills and knowledge to detect, diagnose, and manage MASLD.…”

“…Additionally, this highlights the need for further education and training for PCP on disease diagnosis and management. 107…”

The paradigm shift from NAFLD to MAFLD: A global primary care viewpoint

“…60,6162 Another study reported that 83% of PCPs wanted more education on the topic. 63 There have been calls for greater awareness of the fatty liver disease among PCPs so that diagnosis is not delayed and patients can receive early and appropriate interventions, so we can bridge the gap between evidence and practice.…”

The change from NAFLD to MAFLD expands fatty liver information flow

“…5,6 While another study suggested that more than 83% of primary care providers wanted more education on the topic. 7 In addition, a previous study demonstrated that research outputs related to fatty liver disease have been disproportionally low compared to other liver diseases. 8 There were some varying opinions on the potential impact that this change could have on the already struggling disease awareness.…”