A cross-sectional study of the public health response to non-alcoholic fatty liver disease in Europe

作者：Jeffrey V. Lazarus, Mattias Ekstedt, Giulio Marchesini, Jillian Mullen, Katja Novak, Juan M. Pericàs, Elena Roel, Manuel Romero‐Gómez, Vlad Ratziu, Frank Tacke, Helena Cortez‐Pinto, Quentin M. Anstee · 发表于：Journal of Hepatology · 年份：2019 · DOI：10.1016/j.jhep.2019.08.027 · 被引用次数：170 · 研究领域：Liver Disease Diagnosis and Treatment、Diabetes, Cardiovascular Risks, and Lipoproteins、Alcohol Consumption and Health Effects

BACKGROUND & AIMS: Non-alcoholic fatty liver disease (NAFLD) is a growing public health problem worldwide and has become an important field of biomedical inquiry. We aimed to determine whether European countries have mounted an adequate public health response to NAFLD and non-alcoholic steatohepatitis (NASH). METHODS: In 2018 and 2019, NAFLD experts in 29 European countries completed an English-language survey on policies, guidelines, awareness, monitoring, diagnosis and clinical assessment in their country. The data were compiled, quality checked against existing official documents and reported descriptively. RESULTS: None of the 29 participating countries had written strategies or action plans for NAFLD. Two countries (7%) had mentions of NAFLD or NASH in related existing strategies (obesity and alcohol). Ten (34%) reported having national clinical guidelines specifically addressing NAFLD and, upon diagnosis, all included recommendations for the assessment of diabetes and liver cirrhosis. Eleven countries (38%) recommended screening for NAFLD in all patients with either diabetes, obesity and/or metabolic syndrome. Five countries (17%) had referral algorithms for follow-up and specialist referral in primary care, and 7 (24%) reported structured lifestyle programmes aimed at NAFLD. Seven (24%) had funded awareness campaigns that specifically included prevention of liver disease. Four countries (14%) reported having civil society groups which address NAFLD and 3 countries (10%...