Obesity and Digestive Diseases Unit and Translational Research Unit, Medica Sur Clinic and Foundation, Puente de Piedra 150 Col. Toriello Guerra Tlalpan, 14050, Mexico City, Mexico.
Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico.
Sci Rep. 2022 May 18;12(1):8272. doi: 10.1038/s41598-022-12295-1.
Patients with chronic disorders like non-alcoholic fatty liver disease (NAFLD) face important challenges adhering to diagnostic and treatment tracks. As NAFLD increases, the need to incentivize health-seeking behaviors grows. No evidence-based interventions to address this gap exist. The aim of the study was to estimate the effect of providing increasing levels of diagnostic information on medical care-seeking in adults newly diagnosed with NAFLD. We randomly assigned adults with a sonographic diagnosis of NAFLD at a check-up unit in Mexico to one of five groups. All groups received medical consultation. A: no further interventions; B: received multimedia educational material (MEM); C: MEM + NAFLD-fibrosis-score (NFS); D: MEM + transient elastography (TE); E: MEM + NFS + TE. 1209 participants were randomized, follow-up rate 91%; 82% male, BMI 30.5 ± 4 kg/m. There were no differences in the proportion of patients undergoing further diagnostic evaluation of liver fibrosis (A 0.4%, E 0.4%, P-for-trend = 0.269). Groups who received more information sought specialized medical care more frequently: A 22%, E 30% (P-for-trend = 0.047). A trend to receive treatment was also observed at higher levels of information: A 26.7%, E 36.3% (P-for-trend = 0.134). Increasing the amount of diagnostic information seemed to increase patient's health-seeking. Tailoring the communication of information obtained for diagnosis could help to increase health-seeking in chronic disease patients.Trial registration: NCT01874249 (full date of first registration 11-06-2013).
患有非酒精性脂肪性肝病（NAFLD）等慢性疾病的患者在遵循诊断和治疗方案方面面临着重大挑战。随着 NAFLD 的增加，激励健康寻求行为的需求也在增加。目前尚无针对这一差距的循证干预措施。本研究旨在评估提供不同水平诊断信息对新诊断为 NAFLD 的成年人寻求医疗保健的影响。我们在墨西哥的一个体检单位将超声诊断为 NAFLD 的成年人随机分配到五个组之一。所有组均接受医疗咨询。A 组：无进一步干预；B 组：接受多媒体教育材料（MEM）；C 组：MEM+NAFLD 纤维化评分（NFS）；D 组：MEM+瞬态弹性成像（TE）；E 组：MEM+NFS+TE。共有 1209 名参与者被随机分组，随访率为 91%；82%为男性，BMI 为 30.5±4kg/m。进一步诊断评估肝纤维化的患者比例在各组间无差异（A 组 0.4%，E 组 0.4%，P 趋势=0.269）。接受更多信息的组更频繁地寻求专业医疗保健：A 组 22%，E 组 30%（P 趋势=0.047）。随着信息水平的提高，接受治疗的趋势也观察到：A 组 26.7%，E 组 36.3%（P 趋势=0.134）。增加诊断信息量似乎增加了患者的健康寻求。为诊断获得的信息量身定制沟通方式可能有助于增加慢性疾病患者的健康寻求。试验注册：NCT01874249（首次注册的完整日期为 2013 年 6 月 11 日）。
