ORIGINAL ARTICLE   

Minerva Gastroenterologica e Dietologica 2019 December;65(4):255-8

DOI: 10.23736/S1121-421X.19.02618-7

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Non-alcoholic fatty liver disease: a survey of involvement of primary care physicians

Amir MARI ^{1, 2} ✉, Sohaib OMARI ³, Fadi ABU BAKER ⁴, Saif ABU MUCH ⁴, Helal SAID AHMAD ¹, Tawfik KHOURY ^{1, 2}, William NSEIR ³, Mahmud MAHAMID ^{1, 2}

¹ Section of Gastroenterology, Liver Unit, Nazareth Hospital, Nazareth, Israel; ² Faculty of Medicine, Bar Ilan University, Ramat Gan, Israel; ³ Department of Internal Medicine, Nazareth Hospital, Nazareth, Israel; ⁴ Department of Gastroenterology, Liver Unit, Hilell Yaffe Medical Center, Hadera, Israel

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are neglected in most patients’ electrical medical report by their family physicians (FP). We have assessed whether family physicians have the proper knowledge of NAFLD and accurate training to diagnose and treat NAFLD/NASH in overweight and obese patients.
METHODS: We conducted an anonymous survey questionnaire. Family Physicians who participated completed 4 years of residency and have passed the final examination. Our survey contained questions to measure the physician’s attitudes, source of knowledge and recommendation regarding NAFLD/NASH treatment and attitudes toward patients with NAFLD/NASH. Categorical variables were extracted and analyzed using SPSS.
RESULTS: A total of 310 of 422 FPs were included in the study with a compliance rate of 73%. Our data suggests that 167 of the 310 FPs (55%) refer their patients to a specialist for consultations if they exhibited fatty liver disease. Yet, 284 of 310 send their patients to consolations if exhibiting elevated liver enzyme. Our data significantly suggests that 241 of 310 (78%) reported that they have limited efficacy in treating NAFLD/NASH and consider themselves not properly prepared, by medical schools, to treat NASH/NAFLD patients; as well as patients with obesity and metabolic syndrome without fatty liver.
CONCLUSIONS: FPs are more likely to neglect proper treatment for NAFLD/NASH due to lack of proper knowledge and are more likely neglect referring patients to specialist. Patients with significant obesity and obesity related conditions are more likely to have proactive treatment plans by their FPs.

KEY WORDS: Fatty liver; Physicians, primary care; Surveys and questionnaires