Abstract
BACKGROUND: Non Alcoholic Fatty Liver Disease (NAFLD) is the most common type of liver disease among Canadians that affects 20–40% of Nova Scotians with liver disease. Unfortunately, the current wait time in Nova Scotia to be seen by a hepatology specialist for NAFLD is greater than 18 months. To address this issue a group education program – The Fatty Liver Public Forum (FLPF) was developed to provide information to patients through a panel of experts. The current evidence suggests that diet and exercise are the most effective means of controlling NAFLD treatment should center on weight loss. The FLPF seeks to educate patients about fatty liver disease and provide the opportunity to institute the necessary life style changes while awaiting their clinic appointment. AIMS: To determine the effectiveness of the forum in increasing patient awareness of NAFLD and options for self treatment, as well as its effectiveness in decreasing patient wait times. METHODS: Patients appropriate for the forum were those with prior diagnosis of fatty liver disease by gastroenterologist or by ultrasound. All patients with fatty liver disease were invited to attend the FLPF as incentive to reduce their wait time to see a hepatologist. Patients with cirrhosis, hepatic decompensation, hepatocellular carcinoma were not included as these patients were not felt to benefit from the forum. The FLPF started in February 2014 and has been provided on a quarterly basis. The average wait time from referral to invitation for the FLPF is under 6 months. Furthermore, the average wait time to see the specialist is 10 months for those who have attended the forum. RESULTS: To date 355 individuals have been invited and 135 (38%) have attended, all of whom were asked to complete an evaluation at the end of the clinic visit. Of the 126 attendees who completed the evaluation, 120 (95.2%) reported an increased understanding of what constitutes a fatty liver, 120 (95.2%) reported improved knowledge about healthy diet choices, and 117 (92.8%) reported a greater understanding about weight loss and how to begin an exercise regimen. Preliminary follow up of these patients has shown that 65.9% of patients selected for the forum were deemed appropriate following confirmation through fibroscan or a biopsy. CONCLUSIONS: Of the patients that attended, many patients found the forum educationally beneficial and an appropriate way to begin to manage disease prior to meeting with a specialist. The FLPF is providing improved access to healthcare, a decrease in waitlist times, and increased feelings of self-efficacy in patients with respect to self management of NAFLD. FUNDING AGENCIES: None