Non-alcoholic fatty liver disease (NAFLD) - a new challenge for the healthcare system

Non-alcoholic steatohepatitis (NASH) is the inflammatory, progressive form of non-alcoholic fatty liver disease. The majority of diseases remain undetected due to the non-specific symptoms until serious complications such as liver fibrosis, liver cirrhosis or hepatocellular carcinoma (HCC) occur .

In addition, NASH is associated with an increased risk of type 2 diabetes mellitus (DM2), cardiovascular diseases and obesity. According to the guideline, there is currently no drug therapy to reduce NASH.

NASH is often caused by a lack of exercise or poor diet, which results in obesity. This is where lifestyle interventions come in, but they are rarely used by the affected population. The reasons for the low uptake are poorly understood, especially in relation to subgroups.

This project aims to help close this gap. The aim of the project is, based on the knowledge gained, to generate recommendations for optimized lifestyle change programs as well as for program content that will help the lifestyle change to be successfully implemented.

The optimized programs should take into account the special features of the subgroups and the clinical context. In addition, the preferences of the NASH patients should be compared with the programs identified in the course of the research in order to determine whether suitable programs already exist for certain target groups.

Furthermore, based on the results, an intervention manual for outpatient clinics or specialist practices for the target group-specific introduction of NASH patients and for the successful implementation of suitable lifestyle interventions is to be developed.

Further information can be found on the website of the G-BA Innovationsfonds.

The first step in carrying out the project is a literature search and a screening of the care landscape in order to research lifestyle interventions and best-practice models.

This is followed by an online survey including two Discrete Choice Experiments (DCE) to identify the preferences of the defined target population.

Based on the survey, recommendations for optimized programs are then derived with regard to the target group-specific inclusion of patients in the programs and the guarantee of continuous participation in the lifestyle intervention.

Cooperation partners are the Institute for Epidemiology, Social Medicine and Health System Research; Hannover Medical School; AOK Lower Saxony; Northwest Clinic, Frankfurt. The Advisory Board of the project consists of: VDD, DGEM, German Sport University and Erasmus University Rotterdam, among others. The project is also supported by a patient advisory board.