RecruitingNot ApplicableNCT06671886

NAFLD Clinical Care Pathway

Testing the Effectiveness of NAFLD Clinical Care Pathway in VA Primary Care

Sponsor

VA Office of Research and Development

Enrollment

32 participants

Start Date

Feb 2, 2024

Study Type

INTERVENTIONAL

Conditions

MASLD NAFLD

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

Min Age: 18 Years

Inclusion Criteria1

Patient Aligned Care Teams (PACT) at the Michael E. DeBakey VA Medical Center

Exclusion Criteria6

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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Interventions

BEHAVIORALE-trigger

The NCCP Intervention is multicomponent. First, the investigators will apply the e-trigger and calculate FIB-4, and second, will educate and train PACT personnel on how to deal with trigger positive patients as well as make treatment recommendations within an inter-professional team. The e-trigger will be generated every 3 months. The effectiveness of the trigger will be assessed using the outcomes previously mentioned.