Survey: Chronic Liver Disease Severity May Have Risen Last Year

Industry-sponsored survey of physicians that take care of chronic liver disease patients found evidence that suggests that incidence of severe disease has increased.

Nearly one-fifth of healthcare providers who take care of chronic liver disease patients said they noticed significant increases in the severity of the disease during the last year, according to a new survey.

The Liver Health Annual Trends Report, which includes the results of a survey of 100 physicians active in the management and treatment of chronic liver disease, was recently published by Bausch Health Companies and its gastroenterology business, Salix Pharmaceuticals.

While 18% to 21% of healthcare providers noticed an increase in liver disease disease severity and hospitalizations during COVID-19, the use of telehealth visits helped support them, survey respondents said.

Chronic liver disease affects an estimated 4.5 million adults in the U.S., and more people, ages 25 to 54, die from it and cirrhosis than diabetes or stroke, according to a Bausch news release.

The survey found that physicians said that improving patient outcomes is a top factor influencing the adoption of the American Association for the Study of Liver Diseases (AASLD) guidelines for chronic liver disease, but half (51%) said they don’t abide by the guidelines. Moreover, 38% of survey respondents were unaware of or unable to name national guidelines for the management of chronic liver disease.

Although survey respondents agreed that implementing a standardized approach to care would be optimal, they point to the complexity of chronic liver disease, socioeconomic issues and presence of only a few definitive treatment strategies as impediments to standardizing care.

Other major findings of the survey include:

Patients with nonalcoholic steatohepatitis (NASH) and nonalcoholic fatty liver disease (NAFLD), grouped together, comprise about 40% of chronic liver patients seen by the survey respondents.

Alcohol-induced liver disease (ALD) makes up less than one-third of the liver disease treated by the survey respondents. Treatment adherence and alcohol and recreational drug use are the top two factors determining patient outcomes.

Survey respondents who participated in in-depth interviews indicated that improving the outcomes of patients with end-stage liver disease is difficult given patients' inability to comply with treatment, alcohol and drug use, and treatment for serious comorbidities. Improving patients' health literacy and connecting liver disease to risk factors are critical elements to managing their chronic disease, indicated some respondents.