In particular, metabolic dysfunction-associated steatotic liver disease (MASLD, formerly known as NAFLD) represents a new challenge for the healthcare system

Metabolic dysfunction-associated steatohepatitis (MASH) is the inflammatory, progressive form of MASLD. The majority of the diseases remain undetected due to the non-specific symptoms until serious secondary diseases such as liver fibrosis, liver cirrhosis or hepatocellular carcinoma (HCC) occur.

MASH is also associated with an increased risk of type 2 diabetes mellitus (DM2), cardiovascular disease and obesity. However, according to the guideline, there is currently no drug therapy to reduce MASH.

The cause of MASH is often a lack of exercise or a poor diet, which leads to obesity. This is where lifestyle interventions come in, but they are rarely utilised by the affected population. The reasons for the low utilisation are little researched, especially with regard to subgroups.

This project aims to help close this gap. The aim of the project is to use the findings to generate recommendations for optimised lifestyle change programmes as well as programme content that will contribute to the successful implementation of lifestyle change.

The optimised programmes should take into account the specific characteristics of the subgroups and the clinical context. In addition, the preferences of MASH patients should be compared with the programmes identified in the course of the research in order to determine whether suitable programmes already exist for certain target groups.

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

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

The first step in implementing the project is a literature search and screening of the healthcare 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 optimised programmes are then derived with regard to the target group-specific inclusion of patients in the programmes and ensuring continuous participation in the lifestyle intervention.

Co-operation partners are the Institute for Epidemiology, Social Medicine and Health Systems Research; Hannover Medical School; AOK Lower Saxony; Klinikum Nordwest, Frankfurt. The Advisory Board of the project includes: VDD, DGEM, German Sport University and Erasmus University Rotterdam. The project is also supported by a patient advisory board.