The Scottish Hepatology Access Research Partnership (SHARP) improving access to liver services throughout Scotland

TY - JOUR

T1 - The Scottish Hepatology Access Research Partnership (SHARP) improving access to liver services throughout Scotland

AU - Lynch, Ruairi

AU - Fallowfield, Jonathan

AU - Blane, David

AU - Swann, Rachael

AU - Mills, Kirsty

AU - Cordwell, Amy

AU - Forrest, Ewan

N1 - Publisher Copyright: Copyright: © 2024 Lynch R et al.

PY - 2024/11/27

Y1 - 2024/11/27

N2 - Background and aims Scotland has the highest rate of deaths from chronic liver disease (CLD) in the UK. Socioeconomic and geographic isolation represent significant challenges to delivery of care. The multidisciplinary Scottish Hepatology Access Research Partnership (SHARP) aimed to identify and break down barriers to diagnosing and treating liver disease in Scotland. Methods SHARP comprised a core Partnership Management Group that developed projects and a Partnership Advisory Group which provided oversight. Results SHARP established workstreams to achieve its aims: Understanding current access to liver services To identify barriers to liver patient care in Scotland we audited liver services and surveyed the experience of patients (n=276); primary care physicians (n=199) and Gastroenterologists/Hepatologists (n=99).Technologies to monitor and diagnose CLD Liver disease is diagnosed and monitored using routine blood testing which disadvantages isolated patients. We plan to develop a point of use test to analyse ALT and AST to enable community-based identification and monitoring of liver disease. Identification of patients at risk of liver disease CLD is often diagnosed late. We propose developing an artificial intelligence tool to predict an individual's risk of an emergent admission to hospital due to CLD. This tool will be validated in a Welsh cohort. Barriers to engagement with care for liver disease Hepatology did-not-attend rates are the highest of any specialty. We propose research to co-design a suite of recommendations to improve engagement with care for CLD patients. We aim to achieve this by interviewing practitioners alongside patients who do and don’t engage with services. Conclusions Through a national survey SHARP has developed an understanding of the issues affecting access to hepatology services in Scotland. SHARP has developed projects that will help address the issues that socioeconomically and geographically isolated patients face when it comes to identifying and treating liver disease.

AB - Background and aims Scotland has the highest rate of deaths from chronic liver disease (CLD) in the UK. Socioeconomic and geographic isolation represent significant challenges to delivery of care. The multidisciplinary Scottish Hepatology Access Research Partnership (SHARP) aimed to identify and break down barriers to diagnosing and treating liver disease in Scotland. Methods SHARP comprised a core Partnership Management Group that developed projects and a Partnership Advisory Group which provided oversight. Results SHARP established workstreams to achieve its aims: Understanding current access to liver services To identify barriers to liver patient care in Scotland we audited liver services and surveyed the experience of patients (n=276); primary care physicians (n=199) and Gastroenterologists/Hepatologists (n=99).Technologies to monitor and diagnose CLD Liver disease is diagnosed and monitored using routine blood testing which disadvantages isolated patients. We plan to develop a point of use test to analyse ALT and AST to enable community-based identification and monitoring of liver disease. Identification of patients at risk of liver disease CLD is often diagnosed late. We propose developing an artificial intelligence tool to predict an individual's risk of an emergent admission to hospital due to CLD. This tool will be validated in a Welsh cohort. Barriers to engagement with care for liver disease Hepatology did-not-attend rates are the highest of any specialty. We propose research to co-design a suite of recommendations to improve engagement with care for CLD patients. We aim to achieve this by interviewing practitioners alongside patients who do and don’t engage with services. Conclusions Through a national survey SHARP has developed an understanding of the issues affecting access to hepatology services in Scotland. SHARP has developed projects that will help address the issues that socioeconomically and geographically isolated patients face when it comes to identifying and treating liver disease.

KW - access

KW - chronic liver disease

KW - Hepatology

KW - partnership

KW - socioeconomic deprivation

UR - https://www.scopus.com/pages/publications/85212670741

U2 - 10.3310/nihropenres.13650.2

DO - 10.3310/nihropenres.13650.2

M3 - Article

C2 - 39659734

AN - SCOPUS:85212670741

VL - 4

JO - NIHR Open Research

JF - NIHR Open Research

M1 - 58

ER -