Acceptability of chronic liver disease screening in a UK primary care setting: a qualitative evaluation
Objectives The increasing incidence of chronic liver disease (CLD) in the UK may be attributed to a rise in preventable risk factors, including hazardous alcohol use and type 2 diabetes. Transient elastography (TE) can rapidly stratify risk of CLD in primary care populations and provide an opportuni...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2020-11-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/11/e041574.full |
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| _version_ | 1850159010115747840 |
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| author | Indra Neil Guha Guruprasad Aithal Holly Knight Joanne R Morling David Harman Timothy Card Manpreet Bains |
| author_facet | Indra Neil Guha Guruprasad Aithal Holly Knight Joanne R Morling David Harman Timothy Card Manpreet Bains |
| author_sort | Indra Neil Guha |
| collection | DOAJ |
| description | Objectives The increasing incidence of chronic liver disease (CLD) in the UK may be attributed to a rise in preventable risk factors, including hazardous alcohol use and type 2 diabetes. Transient elastography (TE) can rapidly stratify risk of CLD in primary care populations and provide an opportunity to raise patient awareness of risk factors.This study explores patients’ experiences of TE screening in a primary care setting. In addition, patient awareness of CLD risk is explored.Study design and setting This study used a qualitative process evaluation of a community screening pathway for CLD (Nottingham, UK). Participants completed semistructured interviews, which were audio-recorded, transcribed verbatim and analysed thematically.Participants Twenty adults were purposively recruited 6 months to 2 years after TE screening. Inclusion criteria included (1) hazardous alcohol use, (2) type 2 diabetes and/or (3) persistently elevated liver enzymes without known cause.Results Undergoing TE in primary care was seen as acceptable to most participants. Hazardous alcohol use was identified as the primary cause of CLD; no participants were aware of metabolic risk factors. TE improved understanding of personal risk factors and prompted contemplation of lifestyle changes across all TE stratifications. However, participants’ perceptions of risk were altered by the healthcare providers’ communication of TE scores.Conclusions High acceptability of TE, regardless of the risk factor, provides strong support for inclusion of TE stratification in primary care. Findings highlight the positive impact of receiving TE on risk awareness. Future clinical iterations should improve the structure and communication of TE results to patients. |
| format | Article |
| id | doaj-art-6d2f65cd7f5f4051929f735cbd51a7c3 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-6d2f65cd7f5f4051929f735cbd51a7c32025-08-20T02:23:43ZengBMJ Publishing GroupBMJ Open2044-60552020-11-01101110.1136/bmjopen-2020-041574Acceptability of chronic liver disease screening in a UK primary care setting: a qualitative evaluationIndra Neil Guha0Guruprasad Aithal1Holly Knight2Joanne R Morling3David Harman4Timothy Card5Manpreet Bains6Nottingham University Hospitals, NIHR Nottingham Biomedical Research Centre, Nottingham, UK1 Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham, UKDivision of Epidemiology and Public Health, University of Nottingham, Nottingham, UK1University of Nottingham, Nottingham, UKRoyal Berkshire Hospital NHS Foundation Trust, Reading, UKDivision of Epidemiology and Public Health, University of Nottingham, Nottingham, UKSchool of Medicine, University of Nottingham, Nottingham, UKObjectives The increasing incidence of chronic liver disease (CLD) in the UK may be attributed to a rise in preventable risk factors, including hazardous alcohol use and type 2 diabetes. Transient elastography (TE) can rapidly stratify risk of CLD in primary care populations and provide an opportunity to raise patient awareness of risk factors.This study explores patients’ experiences of TE screening in a primary care setting. In addition, patient awareness of CLD risk is explored.Study design and setting This study used a qualitative process evaluation of a community screening pathway for CLD (Nottingham, UK). Participants completed semistructured interviews, which were audio-recorded, transcribed verbatim and analysed thematically.Participants Twenty adults were purposively recruited 6 months to 2 years after TE screening. Inclusion criteria included (1) hazardous alcohol use, (2) type 2 diabetes and/or (3) persistently elevated liver enzymes without known cause.Results Undergoing TE in primary care was seen as acceptable to most participants. Hazardous alcohol use was identified as the primary cause of CLD; no participants were aware of metabolic risk factors. TE improved understanding of personal risk factors and prompted contemplation of lifestyle changes across all TE stratifications. However, participants’ perceptions of risk were altered by the healthcare providers’ communication of TE scores.Conclusions High acceptability of TE, regardless of the risk factor, provides strong support for inclusion of TE stratification in primary care. Findings highlight the positive impact of receiving TE on risk awareness. Future clinical iterations should improve the structure and communication of TE results to patients.https://bmjopen.bmj.com/content/10/11/e041574.full |
| spellingShingle | Indra Neil Guha Guruprasad Aithal Holly Knight Joanne R Morling David Harman Timothy Card Manpreet Bains Acceptability of chronic liver disease screening in a UK primary care setting: a qualitative evaluation BMJ Open |
| title | Acceptability of chronic liver disease screening in a UK primary care setting: a qualitative evaluation |
| title_full | Acceptability of chronic liver disease screening in a UK primary care setting: a qualitative evaluation |
| title_fullStr | Acceptability of chronic liver disease screening in a UK primary care setting: a qualitative evaluation |
| title_full_unstemmed | Acceptability of chronic liver disease screening in a UK primary care setting: a qualitative evaluation |
| title_short | Acceptability of chronic liver disease screening in a UK primary care setting: a qualitative evaluation |
| title_sort | acceptability of chronic liver disease screening in a uk primary care setting a qualitative evaluation |
| url | https://bmjopen.bmj.com/content/10/11/e041574.full |
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