ArticleDiabetic medicine : a journal of the British Diabetic Association2022
An exploration of barriers and facilitators to implementing a nonalcoholic fatty liver disease pathway for people with type 2 diabetes in primary care.
Article in Diabetic medicine : a journal of the British Diabetic Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- The Asian Pacific association for the study of the liver clinical practice guidelines for the diagnosis and management of metabolic dysfunction-associated fatty liver disease.Hepatology international · 2025Guideline
- Implementation of a nurse-delivered, community-based liver screening and assessment program for people with metabolic dysfunction-associated steatotic liver disease (LOCATE-NAFLD trial).BMC health services research · 2025Trial
- MASLD prevalence, incidence and global aspects.Diabetologia · 2026Review
- Article
- The global cardiovascular-liver-metabolic syndemic: epidemiology, trends and challenges.Nature reviews. Cardiology · 2026Review
- Risk stratification of MASLD/MASH in type 2 diabetes: a pragmatic endocrinology outpatient pathway.Frontiers in endocrinology · 2026Review
- Beyond Awareness: A Qualitative Assessment of Barriers and Facilitators to Implementing Metabolic Dysfunction-Associated Steatotic Liver Disease Care Pathways in Primary Care.Gastro hep advances · 2026Article
- Barriers and facilitators to liver fibrosis screening: Perspectives and practices of Canadian primary care physicians.Canadian liver journal · 2025Article
- Liver diseases and hepatocellular carcinoma in the Asia-Pacific region: burden, trends, challenges and future directions.Nature reviews. Gastroenterology & hepatology · 2024Review
- Article
- Qualitative service evaluation of a multimodal pilot service for early detection of liver disease in high-risk groups: 'Alright My Liver?'BMJ open gastroenterology · 2024Article
- Metabolic Dysfunction-associated Steatotic Liver Disease and Type 2 Diabetes: A Deadly Synergy.TouchREVIEWS in endocrinology · 2024Article
- Safety-Net Primary Care and Endocrinology Clinicians' Knowledge and Perspectives on Screening for Nonalcoholic Fatty Liver Disease: A Mixed-Methods Evaluation.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2024Article
- An Australian Community-Based Metabolic Dysfunction-Associated Steatotic Liver Disease Care Pathway for People with Type 2 Diabetes: Barriers and Considerations.Patient preference and adherence · 2024Article
- Identifying Patients with Nonalcoholic Fatty Liver Disease in Primary Care: How and for What Benefit?Journal of clinical medicine · 2023Review
- Screening for NAFLD-Current Knowledge and Challenges.Metabolites · 2023Review
- An exploration of barriers and facilitators to implementing a nonalcoholic fatty liver disease pathway for people with type 2 diabetes in primary care.Diabetic medicine : a journal of the British Diabetic Association · 2022Article
- Implementing the right care in the right place at the right time for non-alcoholic fatty liver disease (NAFLD-RRR study): a study protocol for a community care pathway for people with type 2 diabetes.BMC health services research · 2022Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsWe explored barriers and facilitators to the implementation of nonalcoholic fatty liver disease (NAFLD) pathway for people with diabetes to identify determinants of behaviour surrounding the diagnosis, assessment and management of NAFLD.
methodsHealth practitioners (n = 24) recruited from multidisciplinary diabetes clinics in primary care (n = 3) and hospital (n = 1) settings participated in four focus group discussions, and common themes were identified using thematic analysis.
resultsLack of knowledge and access to resources were key factors that underpinned an inconsistent approach by clinicians to NAFLD diagnosis and risk stratification and impacted their confidence to discuss the diagnosis with patients. Participants often prioritised other medical issues above NAFLD due to lack of concern about liver-related consequences, reluctance to overburden patients with information, lack of time and perceived absence of accessible fibrosis tests. All participants agreed that implementation of a NAFLD pathway would improve patient care and the general practitioners proposed that screening for NAFLD could be incorporated into routine review cycles for type 2 diabetes. A consistent message from participants was that educating patients about their liver disease needs to be implemented in an integrated care pathway.
conclusionsFrom the perspectives of health practitioners, there is a gap in clinical practice for the implementation of clear, evidence-based guidelines for NAFLD in people with T2D. By focusing on comorbidity prevention and integrating NAFLD as a diabetes complication to be addressed during established cycles of care, many barriers to implementing a NAFLD pathway in primary care could be overcome.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.