Awareness of non-alcoholic steatohepatitis and treatment guidelines: What are physicians telling us?

There is an acute need to raise awareness of non-alcoholic fatty liver disease/non-alcoholic steatohepatitis (NAFLD/NASH) among primary care physicians, endocrinologists and diabetologists to improve patient identification and address the current difficulties in NASH clinical trial enrollment. We examined the extent of knowledge and practice regarding NASH diagnosis and management guidelines. A randomized online convenience survey of 12869 physicians drawn from a national physician database of primary care physicians (PCPs), and gastroenterology and endocrinology specialists were queried via online survey. Our results, based on a cohort of 185 respondents, showed gaps in knowledge and practice between these three groups of practitioners, with primary care providers having the lowest adherence to published guidelines for diagnosis of NASH. Without clear knowledge and patient identification at the point of presentation - which is often in primary care or with specialties other than hepatology-many patients with NAFLD and NASH will remain undiagnosed and untreated, and clinical studies will continue to struggle with patient recruitment, hindering clinical development and optimal patient care.