Mari Amir, Omari Sohaib, Abu Baker Fadi, Abu Much Saif, Said Ahmad Helal, Khoury Tawfik, Nseir William, Mahamid Mahmud
Section of Gastroenterology, Liver Unit, Nazareth Hospital, Nazareth, Israel -
Faculty of Medicine, Bar Ilan University, Ramat Gan, Israel -
Minerva Gastroenterol Dietol. 2019 Dec;65(4):255-258. doi: 10.23736/S1121-421X.19.02618-7. Epub 2019 Oct 24.
Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are neglected in most patients' electrical medical report by their family physicians (FP). We have assessed whether family physicians have the proper knowledge of NAFLD and accurate training to diagnose and treat NAFLD/NASH in overweight and obese patients.
We conducted an anonymous survey questionnaire. Family Physicians who participated completed 4 years of residency and have passed the final examination. Our survey contained questions to measure the physician's attitudes, source of knowledge and recommendation regarding NAFLD/NASH treatment and attitudes toward patients with NAFLD/NASH. Categorical variables were extracted and analyzed using SPSS.
A total of 310 of 422 FPs were included in the study with a compliance rate of 73%. Our data suggests that 167 of the 310 FPs (55%) refer their patients to a specialist for consultations if they exhibited fatty liver disease. Yet, 284 of 310 send their patients to consolations if exhibiting elevated liver enzyme. Our data significantly suggests that 241 of 310 (78%) reported that they have limited efficacy in treating NAFLD/NASH and consider themselves not properly prepared, by medical schools, to treat NASH/NAFLD patients; as well as patients with obesity and metabolic syndrome without fatty liver.
FPs are more likely to neglect proper treatment for NAFLD/NASH due to lack of proper knowledge and are more likely neglect referring patients to specialist. Patients with significant obesity and obesity related conditions are more likely to have proactive treatment plans by their FPs.
在大多数患者的电子病历报告中,家庭医生忽视了非酒精性脂肪性肝病(NAFLD)和非酒精性脂肪性肝炎(NASH)。我们评估了家庭医生是否对NAFLD有足够的了解,以及是否接受过准确的培训,以诊断和治疗超重和肥胖患者的NAFLD/NASH。
我们进行了一项匿名调查问卷。参与的家庭医生完成了4年的住院医师培训并通过了期末考试。我们的调查包含了一些问题,以衡量医生对NAFLD/NASH治疗的态度、知识来源和建议,以及对NAFLD/NASH患者的态度。使用SPSS提取和分析分类变量。
422名家庭医生中有310名纳入研究,依从率为73%。我们的数据表明,310名家庭医生中有167名(55%)如果其患者表现出脂肪性肝病,会将患者转诊给专科医生进行咨询。然而,310名中有284名如果患者肝功能酶升高,会将其送去咨询。我们的数据显著表明,310名中有241名(78%)报告称他们在治疗NAFLD/NASH方面疗效有限,并认为医学院没有让他们做好充分准备来治疗NASH/NAFLD患者;以及没有脂肪肝的肥胖和代谢综合征患者。
由于缺乏适当的知识,家庭医生更有可能忽视对NAFLD/NASH的适当治疗,并且更有可能忽视将患者转诊给专科医生。患有严重肥胖症和与肥胖相关疾病的患者更有可能由其家庭医生制定积极的治疗计划。