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

Jarvis, Helen, Sanders, Tom and Hanratty, Barbara (2022) Liver disease management as routine work in primary care? A qualitative interview study to guide implementation. British Journal of General Practice, 72 (725). e916-e923. ISSN 0960-1643


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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.

Item Type: Article
Additional Information: Funding information: This study was funded by an NIHR clinical DRF (ref: NIHR300716) awarded to HJ.
Uncontrolled Keywords: primary health care, liver diseases, qualitative research, implementation science
Subjects: B100 Anatomy, Physiology and Pathology
B900 Others in Subjects allied to Medicine
L300 Sociology
Department: Faculties > Health and Life Sciences > Social Work, Education and Community Wellbeing
Depositing User: Elena Carlaw
Date Deposited: 01 Jul 2022 09:39
Last Modified: 02 Feb 2023 09:00

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