Liver disease management as routine work in primary care? A qualitative interview study to guide implementation

Helen Jarvis*, Tom Sanders, Barbara Hanratty

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Morbidity from liver disease is rising in the UK. Most cases are caused by alcohol or non-alcoholic fatty liver disease (NAFLD) and treatable if caught early. Liver disease pathways have been shown to increase detection in the community, but have not been adopted into routine primary care work. Aim: To explore primary care health care professional (HCP) experiences and understanding of chronic liver disease, and where it might fit into management of long-term conditions. Design and setting: Qualitative interview study with 20 HCPs in primary care in the North of England. Method: A semi-structured approach informed by a theory of implementation (normalisation process theory (NPT)). Data collection and analysis were concurrent. Interview data were analysed using thematic analysis. Results: Participants identified key areas for action: incentivised frameworks and protocols to drive understanding, organise and sustain practice; inclusion of common liver diseases into multimorbidity care, to reduce complexity and workload, a need to define the GP role within a lifestyle focused treatment pathway, and education/local champions to initiate and legitimise individual and organisational participation in change. Conclusion: To embed chronic liver disease management in routine primary care work, researchers and policy makers must be aware of the implementation challenges. These findings can guide the adoption of effective pathways and help bridge the implementation gap.
Original languageEnglish
Pages (from-to)1-16
Number of pages16
JournalBritish Journal of General Practice (BJGP)
Early online date16 Jun 2022
DOIs
Publication statusE-pub ahead of print - 16 Jun 2022

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