JMIR Publications

ABSTRACT

Background:

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease globally, including India. Despite its high prevalence, there is limited data on its diagnostic and management approaches among Indian healthcare providers. Therefore, this survey was conducted to understand the disease perspective, diagnostic and management strategies for NAFLD/ non-alcoholic steatohepatitis (NASH) among Indian gastroenterologists and hepatologists.

Objective:

To understand the current disease landscape of NAFLD and NASH in clinical practice, focusing on diagnostic methods and management strategies used by hepatologists and gastroenterologists.

Methods:

A cross-sectional survey was conducted among 609 gastroenterologists and hepatologists practicing at healthcare setups/clinics/hospitals located across India from February to May 2023 using a structured, self-administered questionnaire. The questionnaire comprised 34 questions in three categories: Disease perspectives (n=16), Diagnostic modalities (n=4), and Management strategies (n=14), aimed at understanding practitioners' views on NAFLD and NASH. Total 609 participants completed the survey online. The responses were collected, and data was analyzed using descriptive statistics.

Results:

A total of 556 gastroenterologists and 53 hepatologists participated in the survey. For 55% doctors, NAFLD accounted for 25-50% of the patients consulted per month, and 36.1% reported 10-20% of their NAFLD patients were having NASH. Obesity (95.7%) and diabetes (95.1%) were reported as major risk factors for NAFLD. Transient elastography was the preferred diagnostic tool by 91.6% doctors. For treatment, 68% doctors prescribed pharmacotherapy along with dietary and lifestyle modifications. Antioxidant vitamins (89.2%) and Saroglitazar (85.7%) were the most prescribed therapies. Patient’s lack of awareness and limited availability of effective drugs were reported as major barriers in management.

Conclusions:

NAFLD constitutes a major health concern in Indian gastroenterology and hepatology practice. Transient elastography is commonly used for diagnosis, with management often involving pharmacotherapy, dietary, and lifestyle modifications. Lack of patient awareness and effective treatments remain major hurdles in managing NAFLD/NASH.