LOCal Assessment and Triage Evaluation of Non-Alcoholic Fatty Liver Disease (LOCATE – NAFLD)

2019 – 2023

Synopsis

Why the research project was important

NAFLD, a condition in which fat accumulates in the liver in people who drink little or no alcohol, is the most common type of chronic liver disease in Australia and its prevalence is predicted to increase.

Currently, many patients who present to primary care with abnormal liver function tests or steatosis on liver ultrasound are referred for assessment in secondary care. This results in long waits for clinical and fibrosis assessment, placing unnecessary burden on the public hospital system.

What the research sought to do

The LOCATE-NAFLD study was a randomised trial, comparing two alternative models of care for NAFLD (usual care versus LOCATE-NAFLD care).

Participants randomised to the intervention were screened in the community with a non-invasive device called a Fibroscan, a scan they may otherwise have waited months to receive. The scan results can then determined the clinical significance of their disease, with high-risk patients sent to a specialist, and low-risk patients returned to the care of their GP.

What were the research outcomes/ impact

The study aimed to demonstrate a better way of managing NAFLD in the community, quickly identifying patients with clinically significant disease for timely referral into secondary care.

The LOCATE model shows potential for impact, particularly in reducing waiting times for patients at high risk of developing severe liver disease due to NAFLD (read the trial results paper here).

Both patients and referring clinicians found the model to be acceptable, and patients reported reduced anxiety due to decreased wait times (read the implementation results here).