An exploration of barriers and facilitators to implementing a nonalcoholic fatty liver disease pathway for people with type 2 diabetes in primary care.
Aims: We explored barriers and facilitators to the implementation of nonalcoholic fatty liver disease (NAFLD) pathway for people with diabetes to identify determinants of behaviour surrounding the diagnosis, assessment and management of NAFLD. Methods: Health practitioners (n = 24) recruited from mu...
| Publicado en: | Diabetic Medicine Vol. 39; no. 6; pp. 1 - 15 |
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| Autores principales: | , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Jun2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=156806479&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 156806479 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 07423071 F07 jtl: Diabetic Medicine issn: 07423071 maglogo: Y pubinfo: dt: Jun2022 vid: 39 iid: 6 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 156806479 155074786 156806479 156806479 10.1111/dme.14799 156806479 ppf: 1 ppct: 14 formats: tig: atl: An exploration of barriers and facilitators to implementing a nonalcoholic fatty liver disease pathway for people with type 2 diabetes in primary care. aug: au: Gracen, Lucy Hayward, Kelly L. Aikebuse, Melanie Williams, Suzanne Russell, Anthony O'Beirne, James Powell, Elizabeth E. Valery, Patricia C. affil: Centre for Liver Disease Research, Faculty of Medicine, Translational Research Institute, The University of Queensland, Brisbane Queensland,, Australia sug: subj: Nonalcoholic Fatty Liver Disease Diagnosis Nonalcoholic Fatty Liver Disease Therapy Diabetes Mellitus, Type 2 Primary Health Care Critical Path Attitude of Health Personnel Program Implementation Human Male Female Focus Groups Interviews Thematic Analysis Interview Guides Diabetic Patients Multidisciplinary Care Team Professional Knowledge Health Resource Allocation Risk Management Implementation Science Male Female ab: Aims: We explored barriers and facilitators to the implementation of nonalcoholic fatty liver disease (NAFLD) pathway for people with diabetes to identify determinants of behaviour surrounding the diagnosis, assessment and management of NAFLD. Methods: Health practitioners (n = 24) recruited from multidisciplinary diabetes clinics in primary care (n = 3) and hospital (n = 1) settings participated in four focus group discussions, and common themes were identified using thematic analysis. Results: Lack of knowledge and access to resources were key factors that underpinned an inconsistent approach by clinicians to NAFLD diagnosis and risk stratification and impacted their confidence to discuss the diagnosis with patients. Participants often prioritised other medical issues above NAFLD due to lack of concern about liver‐related consequences, reluctance to overburden patients with information, lack of time and perceived absence of accessible fibrosis tests. All participants agreed that implementation of a NAFLD pathway would improve patient care and the general practitioners proposed that screening for NAFLD could be incorporated into routine review cycles for type 2 diabetes. A consistent message from participants was that educating patients about their liver disease needs to be implemented in an integrated care pathway. Conclusions: From the perspectives of health practitioners, there is a gap in clinical practice for the implementation of clear, evidence‐based guidelines for NAFLD in people with T2D. By focusing on comorbidity prevention and integrating NAFLD as a diabetes complication to be addressed during established cycles of care, many barriers to implementing a NAFLD pathway in primary care could be overcome. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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