NAFLD Clinical Care Pathway

Summary

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.

Eligibility

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.

Conditions3

Locations1 site

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