LiverCare

About

Can Fibroscans induce behaviour change in people at risk of liver disease? There are some stark facts about the rise of liver disease in the UK. • Most people who die of liver disease are of working age • Liver disease in the UK has increased by 500% in the last 30 years • People who drink more than 14 units of alcohol a week are at risk of early liver disease • Routine NHS blood tests and ultrasound scans do not detect early liver damage During covid lockdown, the British Medical Journal revealed that alcohol consumption has increased during Covid-19 virus lockdown (Covid-19 and alcohol—a dangerous cocktail, BMJ 2020; 369 https://doi.org/10.1136/bmj.m1987). In my work with Steps Together Rehab, I have witnessed this through an increase in admissions to their rehabilitation unit for people whose work was impacted by lockdown. As a doctor with an interest in the health of the working age population and over 30 years’ experience in helping people with hazardous use of drugs & alcohol, I have seen the power of biofeedback during a consultation to really stimulate change in hazardous substance misuse. For example, using Lung Age as a measure of harm, for people thinking about their smoking, has proven success as a tool to increase quit rates. Is there something for alcohol? Fibroscan TM technology has been recommended by the National Institute for Clinical Excellence (NICE) in 4 publications to assess liver health and reduce the burden of disease in the UK. These are safe and simple scans that give an immediate measure of liver health to clinician and patient. Fibrosis changes detected can be reversed through lifestyle changes. There is very little provision of this technology in NHS primary care and my 2 attempts to stimulate such a service in Leicester has not succeeded. So what next? It feels that the time is right to introduce a liver screening service for people affected. In the next few weeks, I will be piloting a community based Fibroscan service called LiverCare. Starting out as a personal and private service, I hope that RHH Medical, working closely with Steps Together Rehab, will help several people address this area of unmet personal and public health need. We will be looking to whether and how this will motivate people to reduce harm through alcohol. Will liver elasticity scans prove to be as powerful as lung age assessments were for smoking cessation in the noughties? We will collect data that could lead to further research in this space. Do you know anyone who could benefit? Please visit the landing page www.rhhmedical.com/livercare and register an interest. All details submitted will be confidential. Scanning will start in early August. Can you or your organisation support or benefit from this start-up venture? Please visit the landing page and register an interest. We can look into a demonstration of the service in action.