Lifestyle Intervention Framework for Obese Patients with Non-alcoholic Fatty Liver Disease - a Tool for Health Professionals in Resource Constraint Settings.

Charu Arora,Shalimar ,Namrata Singh,Naval K Vikram,Anita Malhotra,Sada Nand Dwivedi,Piyush Ranjan

doi:10.7759/cureus.5999

Abstract

PurposeNon-alcoholic fatty liver disease (NAFLD), is recognized as a health care burden worldwide. Lifestyle modification remains the first line of treatment. However, the real challenge is ensuring the patient's adherence to lifestyle modification measures, especially in hospitals with resource-limited settings.MethodsWe developed a six-month-long, dietitian-led, hospital-based, lifestyle intervention framework for obese NAFLD patients and evaluated its content. Literature review, interviews, and discussions with 10 health experts (general physicians, dietitians/nutritionists, gastroenterologists, and a clinical psychologist) and 45 NAFLD patients (35 in Phase I and 10 in Phase II) in a tertiary hospital of India were carried out.ResultsThe lifestyle intervention framework has unique features, such as an intensive nature to ensure adherence, a comprehensive educational format with clear guidelines, the customization of a prescription as per individual patient requirements, and a holistic approach to inculcate self-monitoring and behavioral change in NAFLD patients.ConclusionHealth professionals worldwide can use this lifestyle intervention framework to develop counseling interventions for better adherence among obese NAFLD patients.

Highlights

Non-alcoholic fatty liver disease (NAFLD) is a rapidly emerging global health concern
The standard care of NAFLD patients in hospitals of developing countries like India involves a quick suggestion of lifestyle modification and prescription of medications for comorbidities by the physician, which is probably not enough to bring out clinically significant results in these patients [2]
We have developed a framework for lifestyle intervention for NAFLD patients

Summary

Introduction

Non-alcoholic fatty liver disease (NAFLD) is a rapidly emerging global health concern. Its prevalence is rising remarkably, in parallel to that of obesity, especially in developing countries such as India [1]. This silent liver condition, if left ignored, may progress to dreadful consequences, such as liver cirrhosis and hepatocellular carcinoma [2]. 50% of NAFLD patients are non-compliant to dietary and lifestyle change advice due to the asymptomatic nature of the disease [5]. The standard care of NAFLD patients in hospitals of developing countries like India involves a quick suggestion of lifestyle modification and prescription of medications for comorbidities by the physician, which is probably not enough to bring out clinically significant results in these patients [2]

Methods

Discussion

Conclusion