September 14, 2020
How to Manage Chronic Fatty Liver Disease Remotely
Chronic fatty liver disease and tips on how best to manage it remotely.
It’s never easy managing a chronic illness, but the global pandemic has introduced new difficulties for patients and care providers alike. Most hospitals are no longer seeing patients for non-critical procedures as waiting rooms and other areas within the hospital are potentially dangerous sites of infection—especially for those with chronic health conditions.
Managing chronic fatty liver disease is especially challenging because sufferers are at risk of infection and seeing the physician at the office has become more difficult. There’s a real lack of confidence and understanding among health professionals regarding the issues. Meanwhile, for patients, the confusing symptoms can make it difficult to diagnose and therefore manage.
In this article, we’ll take a closer look at chronic fatty liver disease and share tips on how best to manage it remotely.
What is Fatty Liver Disease?
Nonalcoholic fatty liver disease (NAFLD) is characterized by excessive accumulation of fat in the liver that is not directly caused by alcohol consumption. According to the National Center for Biotechnology Information, up to 20% of patients with NASH (nonalcoholic steatohepatitis, which is on the spectrum of NAFLD) progress to cirrhosis and eventually develop end-stage liver disease, along with its associated complications.
With the global surge in obesity and type 2 diabetes, the prevalence of NAFLD is on the rise—making solutions to care and remote care all the more crucial.
How is the Disease Diagnosed?
Diagnosis is difficult due to a relative lack of symptoms. Usually, your doctor will start with your medical history, then conduct a physical exam. Thereafter, more tests may be necessary, including one or more of the following:
A Physical Exam
Your doctor will check for inflammation by pressing on your abdomen. Your liver may be inflamed without being enlarged. If nothing is detected using this touch method, they will investigate further.
Blood tests are more definitive. In the case of fatty liver disease, there will be higher levels of liver enzymes present. Specifically, an alanine aminotransferase test (ALT) and aspartate aminotransferase test (AST) will check for this. Fatty liver disease is one reason for elevated enzymes, but it’s not the only one. Therefore, a positive test will likely lead to additional tests.
CT scans, ultrasounds, and MRIs can all show problems like excess fat, scarring, and liver stiffness.
A biopsy is the best way to confirm liver disease. A doctor will remove a piece of tissue and send it to the lab for analysis.
What Challenges Are Associated with Managing the Condition?
Unfortunately, there are limitations in knowledge and unmet needs in the management of NAFLD among medical providers.
In a survey conducted with primary care physicians, 58% expressed a lack of confidence in their knowledge and management of fatty liver disease. The challenge in diagnosing NAFLD may stem from the fact that most patients are asymptomatic, which makes it tricky to pinpoint the disease.
Despite the increasing prevalence of the disease, this lack of knowledge and understanding has led to a lack of research in the area. Currently, there are no drug therapies approved by the Food and Drug Administration (FDA) for the treatment of NAFLD, making diagnosis and disease management challenging.
Remote Counseling and Monitoring
Increasing numbers of patients are relying on remote healthcare practitioners for advice and coaching once diagnosed. Remote Physiologic Monitoring (RPM) uses healthcare technology to monitor patients outside of the physician’s office and provide accessible chronic care management based on real-time information. This means patients can begin the management journey remotely.
Monitoring weight, blood pressure, blood glucose, and heart rate are ways of working with patients remotely to both coach and monitor a patient as they work towards a better outcome.
How Has COVID-19 Impacted the Management of Fatty Liver Disease?
The COVID-19 pandemic poses an enormous challenge to healthcare systems in affected communities. Older patients and those with pre-existing medical conditions, including advanced liver disease and those who have had liver transplants, have been identified as populations at increased risk of infection and/or a severe course of COVID-19.
In line with this increased risk, the CDC advises people with chronic liver disease, as well as others with a higher risk for COVID-19, to stay at home if possible and avoid unnecessary travel.
Given the need for high-risk individuals to stay put when possible, telemedicine has become an important tool for ensuring they receive the necessary care. This also includes remote patient counseling with qualified clinical personnel.
How is Technology Changing Remote Care?
Despite medical advances, lifestyle interventions remain a core part of the therapeutic management of NAFLD.
Remote physiologic monitoring (RPM), was already becoming more popular before the COVID-19 pandemic. It’s now a necessity as providers use technology more often to support their patients’ health. This, in line with a better diet, use of weight apps, constant clinical coaching, and frequent measurement at the office (when available) are part of the proven pathway to a better outcome.
Remote healthcare is easy to implement, convenient, and provides vital care to vulnerable populations as we emerge from the global pandemic. Some of the main ways remote care can be utilized include:
- Telehealth makes it possible for individuals to speak to a professional healthcare provider from the comfort and safety of their own home.
- It also allows patients to avoid possible infections from sitting in a waiting room.
- Apps, video chats, and phone calls widen the accessibility options, making it easier than ever to speak to a professional on your own terms.
- Access to a wider pool of professionals (rather than being limited to those in your immediate area) makes it easier to connect with a NAFLD specialist. It also means wait times are reduced, and contributes to speeding up the rate of care.
How Can ChronWell Help?
The program includes a physician-approved care plan delivered by a team of experts with a strong background in GI, leadership with over 100 years of experience in the GI and healthcare technology space, and a technology footprint that utilizes data from various sources. It also includes direct access to a care navigator, with monthly remote catch-ups that encompass referral management, medication management, and care plan adherence for increased patient satisfaction.
If you’d like to find out more about remote healthcare solutions for chronic conditions, speak to one of our experts today.
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