NAFLD Clinical Care Pathway
Sponsored by VA Office of Research and Development
About this study
Non-alcoholic fatty liver disease (NAFLD) is a new condition that has become the most common chronic liver disease in the world and a main cause of liver cirrhosis, liver failure and liver cancer. Obesity and diabetes, conditions that are very common among Veterans are the main risk factors for NAFLD. Therefore, the burden of NAFLD and its complications among Veterans is substantial. However, most VA patients with NAFLD are undiagnosed and untreated, and their care is not consistent with practice guidelines. The NAFLD Clinical Care Pathway (NCCP) intervention seeks to close this major gap in the care of Veterans by automatically identifying patients at risk of NAFLD, calculating their risk scores of having severe NAFLD, and educating the primary care providers on the diagnosis and treatment of NAFLD. This clinical trial will test the benefit of this NCCP intervention against usual care in increasing the rates of NAFLD diagnosis as well as referral to and enrollment in appropriate treatment. The study will also identify barriers and promotors of future NCCP implementation.
Background: In the United States, non-alcoholic fatty liver disease (NAFLD) affects 25-30% of adults and has become a leading cause of chronic liver disease including cirrhosis and liver cancer. The burden of NAFLD and its complications among patients in the Department of Veterans Affairs (VA) is increasing. Most complications occur among patients with advanced hepatic fibrosis. Treatment (e.g., weight loss) improves patients' outcomes. Significance: The investigator's data indicate that most VA patients with NAFLD are undiagnosed and untreated. There is an urgent need to address this major gap in care. Most people with NAFLD are seen in primary care settings. The NAFLD Clinical Care Pathway (NCCP) is a multistep, algorithmic process that entails identification of patients at risk through…
Where this study is enrolling
- I'm interested
Michael E. DeBakey VA Medical Center, Houston, TX
Houston, Texas
Who can participate
Inclusion criteria
- ✓Patient Aligned Care Teams (PACT) at the Michael E. DeBakey VA Medical Center
Exclusion criteria
- ✕The investigators will exclude PACTs with unstable leadership (i.e., pending departure, vacancy) at time of randomization.
- ✕PACTs participating in the focus groups in Aim 1 will be excluded in Aim 2 to avoid cross contamination.
- ✕PACTs meeting the following criteria will be excluded from randomization in Aim 2:
- ✕PACTs who do not treat NAFLD,
- ✕PACTs not located at the main hospital,
- ✕PACTs with less than 100 visits within 3 months.
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Trial data sourced from ClinicalTrials.gov.