IDEAL CARE: Identifying Advanced Liver Fibrosis in Primary Care – A Multicentre Effectiveness Implementation Trial
Project Details
Chronic liver disease (fibrosis and cirrhosis) is common in Australia and is associated with excess adiposity, alcohol consumption, diabetes, and hepatitis B and C infections. Patients with advanced liver fibrosis have a high risk of developing liver cancer. However, in Australia up to 66% of cirrhosis cases presenting for tertiary care are not detected by a general practitioner (GP) or specialist due to the long asymptomatic phase of the disease.
Recent evidence suggests that an electronic decision-making tool may assist GPs to identify and refer patients at risk of liver fibrosis, thereby reducing their risk of developing liver cancer. However, there is no evidence about the real-world effectiveness of incorporating this tool into general practice regarding whether it can: change practitioner behaviour; improve outcomes for at-risk patients; is cost-effective; and can be applied in rural as well as urban contexts.
The aims of the IDEAL care trial are to determine:
- the effectiveness of an integrated liver fibrosis detection pathway for the diagnosis of unrecognised advanced liver fibrosis in patients at risk of chronic liver disease in urban and rural general practices, compared to usual care.
- the determinants of implementation (barriers and enablers) to understand the contextual factors that influence uptake of the liver fibrosis detection pathway in primary care.
- the cost-effectiveness of an integrated liver fibrosis detection pathway for the prevention of liver related morbidity and mortality.
Project Partners
- The University of Western Australia
- Primary Care Collaborative Cancer Clinical Trials Group (PC4TG)
- Victoria primary care practice-based Research and Education Network (VicREN)
- Prof Leon Adams
- Prof Jon Emery
- A/Prof Jo-Anne Manski-Nankervis
- Prof Alex Thompson
- A/Prof Patty Chondros
- Prof Dougie Boyle
Researchers
- A/Prof Nicole Rankin (Project Lead)
- Dr Tara Clinton-McHarg
Funding
MRFF Grant number: 2023053
Funding period: 2023 – 2027