AN ONLINE TOOLKIT TO IMPROVE PRIMARY CARE PROVIDER IDENTIFICATION OF NON-ALCOHOLIC FATTY LIVER DISEASE

Abstract

Non-alcoholic fatty liver disease (NAFLD) prevalence has reached epidemic proportions and the severe type, non-alcoholic steatohepatitis (NASH) is predicted to become the leading cause of liver transplant over the next two decades. The growing prevalence requires primary care (PC) providers to be adept at recognition and management. However, PC providers experience significant knowledge gaps which can result in delayed access to intervention that could improve outcomes. In response, the online NAFLD toolkit was developed, implemented, and evaluated using the Knowledge to Action framework in an effort to improve knowledge gaps and support evidenced-based practice among PC nurse practitioners (NPs) in a midwestern state. The success of the toolkit was evaluated by administering the NAFLD survey for general practitioners in a pre-post evaluation design. Responses (n=11) were compared for statistical significance using the Wilcoxin signed-rank test for matched pairs and showed improvement in overall knowledge score (p=0.011), perceived comfort scores (p=0.07), and intention to use the non-alcoholic fatty liver disease fibrosis score (NAFLD-FS) for patient monitoring and weight loss for management (p=0.008). The results of this project demonstrate successful implementation of a toolkit to support evidenced-based practice and support expanded use of the toolkit. Continued evaluation on a larger scale is needed.