PTH-145 Cirrhosis Screening with A Portable Fibroscan® Device in a Community Alcohol Support Service: Feasibility Study
| Autor: | M Coulter Smith, R Cetnarskyj, A MacGilchrist, K Matthews |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
education.field_of_study Cirrhosis Referral business.industry Public health Population Gastroenterology Psychological intervention medicine.disease Surgery 03 medical and health sciences Liver disease 0302 clinical medicine Health care Emergency medicine medicine 030211 gastroenterology & hepatology 030212 general & internal medicine Transient elastography business education |
| Zdroj: | Gut. 65:A291.1-A291 |
| ISSN: | 1468-3288 0017-5749 |
| DOI: | 10.1136/gutjnl-2016-312388.548 |
| Popis: | Introduction Alcohol misuse is the major cause of the increase in deaths from liver disease in the UK, 1 particularly in Scotland 2 and particularly in areas of social deprivation. Liver disease usually presents late, with advanced liver disease and cirrhosis often asymptomatic. 3 Patients with alcohol misuse in areas of social deprivation are a “hard to reach” population. This study assessed the feasibility of using a portable Fibroscan® to measure transient elastography (TE), a non-invasive method of assessing hepatic fibrosis, as a screening tool within a community alcohol support service. The study monitored the uptake of a Fibroscan® in individuals accessing one community alcohol support service in a deprived area; determined the apparent prevalence of undiagnosed fibrosis/cirrhosis in participants over a 6 month period; and monitored engagement following referral to specialist liver services of those individuals with TE > 7 kPa. Methods Numbered research information packs were issued on request to individuals who self-identified as harmful drinkers. Consented individuals with a TE > 7 kPa were referred to a nurse-led service within the community service for further tests; results of which determined onward referral to a liver specialist. Participants were monitored for compliance with appointments and follow-up interventions. Results 118 research packs issued with 79 participants: (67%) uptake. 3 unreliable Fibroscan® results (n = 76). 20 (26%) participants had a reading >7 kPa requiring referral to nurse led service. 12 (16%) with indications of significant liver disease requiring onward referral to liver specialist including 5 (7%) indicative of cirrhosis.19/20 (95%) participants requiring referral to nurse led service attended for further investigations.11/12 (92%) participants requiring onward referral to specialist services attended initial appointment. Conclusion A 67% uptake suggests a nurse led Fibroscan® service in a community alcohol service is acceptable. Early indications show a high compliance with liver services offering potential for early intervention and improved health outcomes. References 1 British Association for the Study of the Liver and British Society of Gastroenterology 2009. The National Plan for Liver Services. A time to act: improving liver health and outcomes in liver disease. 2 Scottish Public Health Observatory 2015 . Public Health Information for Scotland. 3 Williams R, et al. Addressing liver disease in the UK: a blueprint for attaining excellence in health care and reducing premature mortality from lifestyle issues of excess consumption of alcohol, obesity, and viral hepatitis. Lancet. 2014; 384: 1953–1997. Disclosure of Interest None Declared |
| Databáze: | OpenAIRE |
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