Research project to tackle ‘silent’ liver condition

A Teesside University academic is leading on work across the region to develop partnerships to identify how non-alcoholic fatty liver disease (NAFLD) can be better detected and managed.

NAFLD affects around one in three people in the UK. It is primarily caused by a build-up of fat in the liver and is mostly seen in people with obesity. Early-stage NAFLD is typically asymptomatic and does not usually cause harm, but it can lead to serious liver damage and end-stage liver disease for some people.

There are currently no drug treatments for NAFLD and the main treatment is lifestyle change, with weight loss being central to improving liver health. Despite the positive effect of lifestyle change on liver health, structured lifestyle programmes for NAFLD are not routinely available in clinical care.

Professor Leah Avery, from the University’s School of Health & Life Sciences, has been awarded funding from the Efficacy and Mechanism Evaluation (EME) Programme, a National Institute for Health and Care Research (NIHR) and Medical Research Council (MRC) partnership, to work on a project supported by Fuse, the Centre for Translational Research in Public Health. Fuse is a collaboration of the five North East universities, including Teesside University.

She is also working collaboratively on a separate project with Dr Kate Hallsworth, from Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University.

The funding will enable Professor Avery to work in practice and community partners with the aim of developing research proposals designed to effectively detect and manage NAFLD across the Tees Valley region.

She said: “We are looking to develop partnerships across the Tees Valley, to involve health, community and voluntary organisations and members of the public, to get them working together to look at how we can detect NAFLD and develop solutions.

“We can encourage and support people to lose weight short-term, but once this support stops, weight is typically regained. Therefore, more sustainable, long-term solutions are required that work at community level.

“We want to find out what type of support people with NAFLD need and where they need it from. We need to develop services in the community to relieve the pressure on the NHS given the scale of NAFLD.

“NAFLD is a silent condition. Symptoms can include fatigue and a dull ache in the liver. Most people may not put it down to any particular condition, until detected. There are no pharmaceutical interventions which can help, and it can be hard to detect. The reason for this partnership is to improve detection and to help with early intervention of NAFLD.”

AAs part of the EME-funded project to build a partnership hub to help detect and manage NAFLD, an online event will be held with Fuse. This event will be on Wednesday 19 April, 9.30am to 11:30am. It is open to anyone with an interest in NAFLD, from those interested in risk factors of the disease, such as obesity, pre-diabetes and low levels of physical activity, to those interested in health inequalities and behaviour change. Book a place.

Professor Avery is also working collaboratively with Dr Kate Hallsworth, from Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, to evaluate a digital self-management intervention for people with NAFLD.

Led by Dr Hallsworth, this evidence-informed intervention called ‘VITALISE’ offers remote access to an online platform, supported by lifestyle coaches to work with patients to achieve clinically meaningful weight loss.

Professor Avery said: “Currently there are no structured evidence-based lifestyle interventions used routinely in clinical care to help patients with NAFLD to lose weight. Essentially, they are simply advised to lose weight without the support to achieve this. NAFLD is progressive and can lead to further problems and serious liver damage, including cirrhosis in some patients, if not tackled.

“Dr Hallsworth and I, along with other colleagues in Newcastle, have worked for the past eight years on a programme of NAFLD research that has led to the development of a digital lifestyle intervention. This intervention offers structured education and behaviour change tools available to patients online.

“NAFLD is primarily a dietary and lifestyle-related disease and VITALISE provides patients with an opportunity to self-manage their condition with ongoing support.”

Patients will take part in the VITALISE programme for six months, with support to help them to set personalised goals linked to dietary and physical activity behavioural change to achieve weight loss.

Professor Avery said: “Feedback from patients will be used to help shape future use of the programme, to help improve usability and inclusivity. We will also collect preliminary data on clinical outcome measures as part of routine care.

“If this project proves feasible to deliver, it could create a scalable means of implementing clinical guidelines into practice. It will be the first study to provide evidence for the feasibility of using VITALISE in routine clinical care for patients with NAFLD. We will use this data to inform a future funding application to allow a larger scale evaluation of VITALISE in the NHS.”

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