Borriello R, Esposto G, Mignini I, Gasbarrini A, Zocco MA. Quantitative assessment of self-management in patients with non-alcoholic fatty liver disease: An unmet clinical need. World J Gastroenterol 2024; 30(25): 3143-3146 [PMID: 39006382 DOI: 10.3748/wjg.v30.i25.3143]
Corresponding Author of This Article
Maria Assunta Zocco, MD, PhD, Researcher, CEMAD Digestive Disease Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Rome, Largo Gemelli 1, Rome 00168, Italy. mariaassunta.zocco@unicatt.it
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Jul 7, 2024; 30(25): 3143-3146 Published online Jul 7, 2024. doi: 10.3748/wjg.v30.i25.3143
Quantitative assessment of self-management in patients with non-alcoholic fatty liver disease: An unmet clinical need
Raffaele Borriello, Giorgio Esposto, Irene Mignini, Antonio Gasbarrini, Maria Assunta Zocco
Raffaele Borriello, Giorgio Esposto, Irene Mignini, Antonio Gasbarrini, Maria Assunta Zocco, CEMAD Digestive Disease Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Rome, Rome 00168, Italy
Author contributions: Borriello R and Zocco MA conceived and outlined the manuscript; Borriello R reviewed the literature and wrote the manuscript; Esposto G and Mignini I contributed to the review and editing of the manuscript; Esposto G, Gasbarrini A and Zocco MA supervised the manuscript preparation and the submission process.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose regarding this paper.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Maria Assunta Zocco, MD, PhD, Researcher, CEMAD Digestive Disease Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Rome, Largo Gemelli 1, Rome 00168, Italy. mariaassunta.zocco@unicatt.it
Received: March 20, 2024 Revised: May 13, 2024 Accepted: June 11, 2024 Published online: July 7, 2024 Processing time: 102 Days and 16.8 Hours
Abstract
In this editorial we comment on the article titled “Establishment and validation of an adherence prediction system for lifestyle interventions in non-alcoholic fatty liver disease” by Zeng et al published in a recent issue of the World Journal of Gastroenterology. Non-alcoholic fatty liver disease (NAFLD) represents one of the current challenges in hepatology and public health, due to its continuous growing prevalence and the rising incidence of NAFLD-related fibrosis, non-alcoholic steatohepatitis and cirrhosis. The only effective therapeutic strategy for this disease is represented by encouraging patients to improve their lifestyle through the modification of dietary intake and increased physical exercise, but the effective application of such modifications is often limited by various factors such as lack of information, psychological barriers or poor social support. While poor adherence to a healthy lifestyle can be decisive in determining the clinical outcome, in daily practice there is a lack of quantitative instruments aimed at identifying patients with the lowest adherence to lifestyle changes and higher risk of disease progression in the course of follow-up. In this article, Zeng et al propose a quantitative scale to assess the grade of adherence of patients with NAFLD to healthy lifestyle intervention, called the Exercise and Diet Adherence Scale (EDAS). This scale, consisting of 33 items divided into 6 dimensions which relates to six subjective aspects in the self-management of NAFLD, has shown a good correlation with the identification of the sub-cohort of patients with the highest reduction in caloric intake, increase in physical exercise, probability of a reduction in liver stiffness measurement and alanine aminotransferase levels. The correlation among clinical outcomes and specific dimensions of this scale also highlights the pivotal role of a good and confidential doctor-patient relationship and of an effective communication. There is an urgent need for practical and effective instruments to assess the grade of self-management of NAFLD patients, together with the development of multidisciplinary teams with the aim of applying structured behavioral interventions.
Core Tip: Although the only therapeutic strategy in patients affected by non-alcoholic fatty liver disease is represented by a modification in their lifestyle and dietary habits, today there are still no validated instruments to perform a quantitative evaluation of the grade of self-management and self-care of these patients. In this editorial, we comment on a new score proposed recently which could fill this gap in clinical practice, and highlight the urgent need for effective instruments to assess this aspect together with the development of multidisciplinary teams with the aim of applying structured behavioral interventions.
