Quality standards for the management of alcohol-related liver disease: consensus recommendations from the British Association for the Study of the Liver and British Society of Gastroenterology ARLD special interest group

Richard Parker (Lead / Corresponding author), Michael Allison, Seonaid Anderson, Richard Aspinall, Sara Bardell, Vikram Bains, Ryan Buchanan, Lynsey Corless, Ian Davidson, Pauline Dundas, Jeff Fernandez, Ewan Forrest, Erica Forster, Dennis Freshwater, Ruth Gailer, Robert Goldin, Vanessa Hebditch, Steve Hood, Arron Jones, Victoria LaversDeborah Lindsay, James Maurice, Joanne McDonagh, Sarah Morgan, Tania Nurun, Christopher Oldroyd, Elizabeth Oxley, Sally Pannifex, Graham Parsons, Thomas Phillips, Nicole Rainford, Neil Rajoriya, Paul Richardson, J. Ryan, Joanne Sayer, Mandy Smith, Ankur Srivastava, Emma Stennett, Jennifer Towey, Roya Vaziri, Ian Webzell, Andrew Wellstead, Ashwin Dhanda, Steven Masson

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)
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Abstract

Objective: Alcohol-related liver disease (ALD) is the most common cause of liver-related ill health and liver-related deaths in the UK, and deaths from ALD have doubled in the last decade. The management of ALD requires treatment of both liver disease and alcohol use; this necessitates effective and constructive multidisciplinary working. To support this, we have developed quality standard recommendations for the management of ALD, based on evidence and consensus expert opinion, with the aim of improving patient care.

Design: A multidisciplinary group of experts from the British Association for the Study of the Liver and British Society of Gastroenterology ALD Special Interest Group developed the quality standards, with input from the British Liver Trust and patient representatives.

Results: The standards cover three broad themes: the recognition and diagnosis of people with ALD in primary care and the liver outpatient clinic; the management of acutely decompensated ALD including acute alcohol-related hepatitis and the posthospital care of people with advanced liver disease due to ALD. Draft quality standards were initially developed by smaller working groups and then an anonymous modified Delphi voting process was conducted by the entire group to assess the level of agreement with each statement. Statements were included when agreement was 85% or greater. Twenty-four quality standards were produced from this process which support best practice. From the final list of statements, a smaller number of auditable key performance indicators were selected to allow services to benchmark their practice and an audit tool provided.

Conclusion: It is hoped that services will review their practice against these recommendations and key performance indicators and institute service development where needed to improve the care of patients with ALD.
Original languageEnglish
Article numbere001221
Number of pages13
JournalBMJ Open Gastroenterology
Volume10
Issue number1
Early online date4 Oct 2023
DOIs
Publication statusPublished - 4 Oct 2023

Keywords

  • Alcohol
  • alcoholic liver disease
  • liver

ASJC Scopus subject areas

  • Gastroenterology

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