TY - JOUR T1 - Implementation of a care bundle improves the management of patients with non-alcoholic fatty liver disease JF - Frontline Gastroenterology JO - Frontline Gastroenterol DO - 10.1136/flgastro-2020-101480 SP - flgastro-2020-101480 AU - Laura Jane Neilson AU - Louise Macdougall AU - Phey Shen Lee AU - Timothy Hardy AU - David Beaton AU - Subashini Chandrapalan AU - Alaa Ebraheem AU - Mohammed Hussien AU - Sarah Galbraith AU - Shi Looi AU - Sophia Oxenburgh AU - Naw April Phaw AU - William Taylor AU - Laura Haigh AU - Kate Hallsworth AU - Dina Mansour AU - Jessica K Dyson AU - Steven Masson AU - Quentin Anstee AU - Stuart McPherson Y1 - 2021/01/04 UR - http://fg.bmj.com/content/early/2021/01/03/flgastro-2020-101480.abstract N2 - Background Non-alcoholic fatty liver disease (NAFLD) is common and is associated with liver-related and cardiovascular-related morbidity. Our aims were: (1) to review the current management of patients with NAFLD attending hospital clinics in North East England (NEE) and assess the variability in care; (2) develop a NAFLD ‘care bundle’ to standardise care; (3) to assess the impact of implementation of the NAFLD care bundle.Methods A retrospective review was conducted to determine baseline management of patients with NAFLD attending seven hospitals in NEE. A care bundle for the management of NAFLD was developed including important recommendations from international guidelines. Impact of implementation of the bundle was evaluated prospectively in a single centre.Results Baseline management was assessed in 147 patients attending gastroenterology, hepatology and a specialist NAFLD clinic. Overall, there was significant variability in the lifestyle advice given and management of metabolic risk factors, with patients attending an NAFLD clinic significantly more likely to achieve >10% body weight loss and have metabolic risk factors addressed. Following introduction of the NAFLD bundle 50 patients were evaluated. Use of the bundle was associated with significantly better documentation and implementation of most aspects of patient management including management of metabolic risk factors, documented lifestyle advice and provision of NAFLD-specific patient advice booklets.Conclusion The introduction of an outpatient ‘care bundle’ led to significant improvements in the assessment and management of patients with NAFLD in the NEE and could help improve and standardise care if used more widely. ER -