TY - JOUR
T1 - Guideline-based management of metabolic dysfunction-associated steatotic liver disease in the primary care setting
AU - Allen, Alina M.
AU - Charlton, Michael
AU - Cusi, Kenneth
AU - Harrison, Stephen A.
AU - Kowdley, Kris V.
AU - Noureddin, Mazen
AU - Shubrook, Jay H.
N1 - Publisher Copyright:
© 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2024/5/13
Y1 - 2024/5/13
N2 - Background: The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) is increasing worldwide. Primary care providers play a critical role in the screening, diagnosis, and management of MASLD and/or metabolic dysfunction-associated steatohepatitis (MASH), though they can face challenges in this setting, particularly where healthcare resources are limited and barriers to care exist. To address these challenges, several guidelines have been developed to provide evidence-based recommendations for the clinical assessment and management of patients with MASLD/MASH. Aims: To provide a unified, simple-to-understand, practical guide for MASLD screening, diagnosis, and management based on current guideline recommendations, for use by primary care providers in daily practice. Methods: Evidence-based recommendations from several international guidelines were summarized, focusing on the similarities and differences between them. Results: Recommendations are broadly aligned across the guidelines, but several key differences are evident. Practical guidance is provided on screening, identifying target populations for risk stratification, initial evaluation of individuals with suspected MASLD, surveillance, risk stratification and referral, as well as approaches to the management of MASLD and associated comorbidities, with specific considerations for the primary care setting. Conclusions: Primary care providers are ideally placed to identify at-risk individuals, implement evidence-based interventions to prevent the development of fibrosis and cirrhosis, and effectively manage comorbidities. Equipping primary care providers with the necessary knowledge and tools to effectively manage MASLD/MASH may help to improve patient outcomes and reduce the burden of liver disease.
AB - Background: The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) is increasing worldwide. Primary care providers play a critical role in the screening, diagnosis, and management of MASLD and/or metabolic dysfunction-associated steatohepatitis (MASH), though they can face challenges in this setting, particularly where healthcare resources are limited and barriers to care exist. To address these challenges, several guidelines have been developed to provide evidence-based recommendations for the clinical assessment and management of patients with MASLD/MASH. Aims: To provide a unified, simple-to-understand, practical guide for MASLD screening, diagnosis, and management based on current guideline recommendations, for use by primary care providers in daily practice. Methods: Evidence-based recommendations from several international guidelines were summarized, focusing on the similarities and differences between them. Results: Recommendations are broadly aligned across the guidelines, but several key differences are evident. Practical guidance is provided on screening, identifying target populations for risk stratification, initial evaluation of individuals with suspected MASLD, surveillance, risk stratification and referral, as well as approaches to the management of MASLD and associated comorbidities, with specific considerations for the primary care setting. Conclusions: Primary care providers are ideally placed to identify at-risk individuals, implement evidence-based interventions to prevent the development of fibrosis and cirrhosis, and effectively manage comorbidities. Equipping primary care providers with the necessary knowledge and tools to effectively manage MASLD/MASH may help to improve patient outcomes and reduce the burden of liver disease.
KW - Diagnosis
KW - guideline
KW - metabolic dysfunction-associated steatohepatitis
KW - metabolic dysfunction-associated steatotic liver disease
KW - primary care
KW - treatment
KW - Risk Assessment
KW - Humans
KW - Primary Health Care
KW - Fatty Liver/therapy
KW - Practice Guidelines as Topic
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U2 - 10.1080/00325481.2024.2325332
DO - 10.1080/00325481.2024.2325332
M3 - Review article
C2 - 38465573
AN - SCOPUS:85192802940
SN - 0032-5481
VL - 136
SP - 229
EP - 245
JO - Postgraduate medicine
JF - Postgraduate medicine
IS - 3
ER -