TBA (22W145)

“Now For The New Normal?” New Patients And The Need For A Nurse Specialist Hepatology Clinic


Dr Aoife Moriarty, Ms Caroline Walsh, Dr Eleanor Ryan, Dr Jennifer Russell, Prof Stephen Stewart


The Liver Centre, Mater Misericordiae University Hospital, Dublin


New patient referrals to specialist hepatology clinics are increasing, particularly in the context of the metabolic associated liver disease epidemic. Concentrated efforts are required to establish which patients referred can be managed in primary care, thus improving specialist access for more complex cases.


The aims of this prospective study were to evaluate new referrals to hepatology clinic in MMUH and to assess the impact of a hepatology nurse specialist on clinic outcomes


New patients to clinic were reviewed by a hepatology nurse specialist. A questionnaire was completed including referral details, basic demographics and alcohol consumption data. Bloods (including liver screen) and transient elastography were performed. Patients with alcohol or non-alcohol related steatosis with low elastography scores were planned to be discharged to GP with lifestyle advice.


200 new patients were reviewed in 3 months, 94 females and 106 males, average age of 50.93 years (+/-14.91 SD). Patients had an average BMI of 29.06kg/m2 (+/-7.09 SD) and median elastography scores of 6.2kPa(IQR 6.65), 255.5 CAP (IQR 89.25). 71% were referred by GP, with the majority of these (44%) referred due to abnormal blood results. Steatosis was the most common diagnosis (43%) made at clinic. 67% of patients consumed alcohol. Following this visit, 40% of referrals were discharged to their GP without requiring further review. 57% of patients with steatosis were discharged.


A hepatology nurse specialist clinic is a useful adjunct for managing new referrals, delivering targeted patient advice and achieving a high rate of discharge, particularly in the uncomplicated steatosis population.

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