Deploying a metabolic dysfunction-associated steatohepatitis consensus care pathway: findings from an educational pilot in three health systems

作者：Sonal Kumar, Arpan Mohanty, Parvez Mantry, Robert E. Schwartz, Madeleine Haff, George Therapondos, Mazen Noureddin, Douglas T. Dieterich, Nigel Girgrah, Kristi Cohn, Mohanish Savanth, Michael Fuchs · 发表于：BMC Family Practice · 年份：2024 · DOI：10.1186/s12875-024-02517-y · 被引用次数：5 · 研究领域：Liver Disease Diagnosis and Treatment、Diabetes Management and Education、Hepatitis C virus research

BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly referred to as nonalcoholic fatty liver disease, impacts 30% of the global population. This educational pilot focused on the role primary care providers may play in the delivery of guidelines-based metabolic dysfunction-associated steatohepatitis (MASH) care. OBJECTIVE: Accelerate the application of guidelines-based MASH care pathways to clinical workflows. METHODS: A panel of six hepatologists was convened in 2021 to develop the care pathway and the subsequent pilot occurred between 2022 - 2023. The pilot was conducted across three U.S. health systems: Boston Medical Center (Boston), Methodist Health System (Dallas), and Weill Cornell Medicine (New York). Clinicians were educated on the care pathway and completed baseline/follow-up assessments. 19 primary care clinicians participated in the educational pilot baseline assessment, nine primary care clinicians completed the two-month assessment, and 15 primary care clinicians completed the four-month assessment. The primary endpoint was to assess clinician-reported adherence to and satisfaction with the care pathway. The pilot was deemed exempt by the Western Consensus Group Institutional Review Board. RESULTS: At baseline, 38.10% (n = 8) of respondents felt they had received sufficient training on when to refer a patient suspected of metabolic dysfunction-associated liver disease to hepatology, and 42.86% (n = 9) had not referred any patient...