Transforming the landscape of liver disease in the UK

Abstract

In 2014, The Lancet published the inaugural report of the Lancet Commission on Liver Disease in the UK. 1 Williams R Aspinall R Bellis M et al. Addressing liver disease in the UK: a blueprint for attaining excellence in health care and reducing premature mortality from lifestyle issues of excess consumption of alcohol, obesity, and viral hepatitis. Lancet. 2014; 384: 1953-1997 Summary Full Text Full Text PDF PubMed Scopus (405) Google Scholar With mortality from liver diseases having risen four-fold over the previous four decades, the report was timely and urgently needed. Led by Roger Williams of the UK's Foundation for Liver Research, Institute of Hepatology, King's College London, the Commission provided a comprehensive analysis of the disease burden in the UK and carefully examined access to, and quality of, care for patients with liver disease. Having accumulated a strong foundation of evidence, the Commission made ten recommendations aimed at reducing unacceptable premature mortality and improving care for patients. The recommendations addressed unmet needs of patients with liver disease, as well as areas in which the greatest population-wide impacts could be made. They covered the full spectrum of health care, including community, general practice, specialised services, and paediatric care. Obesity, alcohol, and hepatitis were identified as key modifiable risk factors. The need for a response to commercial drivers of poor liver health—the alcohol and food industries—was also highlighted as a priority area to focus political action. Gathering momentum for the way ahead: fifth report of the Lancet Standing Commission on Liver Disease in the UKThis report presents further evidence on the escalating alcohol consumption in the UK and the burden of liver disease associated with this major risk factor, as well as the effects on hospital and primary care. We reiterate the need for fiscal regulation by the UK Government if overall alcohol consumption is to be reduced sufficiently to improve health outcomes. We also draw attention to the effects of drastic cuts in public services for alcohol treatment, the repeated failures of voluntary agreements with the drinks industry, and the influence of the industry through its lobbying activities. Full-Text PDF Place of death and factors associated with hospital death in patients who have died from liver disease in England: a national population-based studyThe high risk of hospital death in patients with sepsis, hepatorenal syndrome, or peritonitis warrants further investigation, and the low chance of hospital death in patients with alcohol-related disorders also needs to be explored. Prevention strategies and end-of-life care services are urgently needed to prevent and tackle harms from liver disease. Full-Text PDF Alcohol drinking patterns and liver cirrhosis risk: analysis of the prospective UK Million Women StudyIn middle-aged women, cirrhosis incidence increases with total alcohol intake, even at moderate levels of consumption. For a given weekly intake of alcohol, this excess incidence of cirrhosis is higher if consumption is usually without meals, or with daily drinking. Full-Text PDF Open Access