Observations Involving Demographic Disparities Within Community Based Referral of NAFLD Patients

Observations Involving Demographic Disparities Within Community Based Referral of NAFLD patients Names: Daniel J. Kurtz, Gregory A. Galmin, Jovanna Arce, Gabriella Hernandez, Keianna Hawthorne, Anna Nguyen, Joshua Ghansiam, Melisa Escobar, and Guy W. Neff Institution: Covenant Research and Clinics, LLC Introduction: NAFLD has presently resulted into a healthcare crisis, with \u3e40% of the US population suffering from NAFLD. People suffering from NAFLD may have liver-based inflammation, also known as, non-alcoholic steatohepatitis (NASH) or a non-inflammatory pathway non-alcoholic fatty liver (NAFL). Rarely does NAFLD lead to symptoms until the disease has progressed to cirrhosis, thus early diagnosis is critical to survival. The aim of the project is to identify trends involving referral patterns, diagnostic modalities, and Echosensâ„¢ FibroScan testing related to NAFLD patients. Methods: Data was collected from referred NAFLD patients and analyzed based on gender, ethnicity, hip and waist circumference, BMI, and various lab values. The patients were analyzed on their attendance compliance and qualification status. Results: Data collected showed 395 referred patients. 97 (24.6%) qualified for the trial screening and 175 did not qualify, with the remaining being either non-compliant with their visit or considered to have normal results. Of the 175 patients who did not qualify, 75 (19.0%) did not qualify due to kPa requirements, 63 (15.9%) did not qualify for other exclusions, and 32 (8.1%) did not qualify due to concomitant medications (CM), and 5 (1.3%) did not qualify due to both CM and kPa requirements. Overall referrals, 49 (12.4%) patients were non-compliant with referral visits, while 74 (18.7%) patients were deemed to have normal laboratory and Echosensâ„¢ FibroScan results. The primary disqualifying factor from NAFLD trials was current CM: either more time needed to acclimate to their medication and meet protocol criteria, or the medication was prohibited by the study altogether. In term of ethnicity, every ethnicity presented similar BMIs and HbA1cs throughout with an overall average of 33.2kg/m2 (n=395) and 6.5% (n=395), respectively. Continuing, all patients had a degree of transaminitis within the sample being collected. However, White and Caucasians had the highest average CAP score and kPa on Echosensâ„¢ FibroScan. Conclusions: The above data reveals a large percentage of patients referred for NAFLD management do not meet criteria or do not comply with referral. This data is important and will guide our efforts to better understand referral processes and education gaps while improving research opportunities for patients suffering from NAFL or NASH