HealthDay News — A nurse-led primary care intervention can increase the number of new diagnoses of liver disease, according to a study published online Dec. 21 in PLOS ONE.
Magdy El-Gohary, BSc, BM, from the University of Southampton in the United Kingdom, and colleagues randomly assigned 10 general practitioner (GP) practices to an intervention, with nurse-led primary care-based liver clinics using additional noninvasive testing, or care as usual. To ascertain baseline prevalence of liver disease, pre-recruitment audits were carried out in each practice. Participants were then recruited via GP referral, nurse-led case findings based on risk factors, or random AUDIT questionnaire mail-outs.
A total of 910 participants were seen in the nurse-led clinic: 4.8% with probable cirrhosis, 15.5% with progressive fibrosis, 24.2% with liver warning, and 55.5 % with no evidence of liver fibrosis. The researchers found that 49.5 and 39.1% of cases were due to nonalcoholic fatty liver disease and alcohol, respectively. For the 405 patients with a liver disease diagnosis, 33.6, 53.8, and 12.6% were referred by GP, nurse-led case finding, and the AUDIT mail-out, respectively. A total of 544 incident cases were identified in the intervention arm compared with 221 in the control arm (adjusted odds ratio, 2.4).
“Incorporating a liver nurse within primary care was simple to arrange and yielded a much higher number of new diagnoses of liver disease compared to usual care,” El-Gohary said in a statement.
One author disclosed financial ties to the pharmaceutical industry.