Critical shortfalls in the management of PBC: Results of a UK-wide, population-based evaluation of care delivery
Abstract
We obtained data for 8,968 patients with PBC and identified substantial gaps in care across all guideline domains. Ursodeoxycholic acid (UDCA) was used as first-line treatment in 88% of patients (n = 7,864) but was under-dosed in one-third (n = 1,964). Twenty percent of patients who were UDCA-untreated (202/998) and 50% of patients with inadequate UDCA response (1,074/2,102) received second-line treatment. More than one-third of patients were not assessed for fatigue (43%; n = 3,885) or pruritus (38%; n = 3,415) in the previous 2 years. Fifty percent of all patients with evidence of hepatic decompensation were discussed with a liver transplant centre (222/443). Appropriate use of second-line treatment and referral for liver transplantation was significantly better in specialist PBC treatment centres compared with non-specialist centres (p <0.001).
Author
Abbas, Nadir
Smith, Rachel
Flack, Steven
Bains, Vikram
Aspinall, Richard J
Jones, Rebecca L
Burke, Laura
Thorburn, Douglas
Heneghan, Michael
Yeoman, Andrew
Leithead, Joanna
Braniff, Conor
Robertson, Andrew
Mitchell, Chris
Thain, Collette
Mitchell-Thain, Robert
Jones, David
Trivedi, Palak J
Mells, George F
Alrubaiy, Laith
Smith, Rachel
Flack, Steven
Bains, Vikram
Aspinall, Richard J
Jones, Rebecca L
Burke, Laura
Thorburn, Douglas
Heneghan, Michael
Yeoman, Andrew
Leithead, Joanna
Braniff, Conor
Robertson, Andrew
Mitchell, Chris
Thain, Collette
Mitchell-Thain, Robert
Jones, David
Trivedi, Palak J
Mells, George F
Alrubaiy, Laith
Citations
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Date
2023-10-16
Type
Article
Subject
Gastroenterology
Collections
Citation
Abbas N, Smith R, Flack S, Bains V, Aspinall RJ, Jones RL, Burke L, Thorburn D, Heneghan M, Yeoman A, Leithead J, Braniff C, Robertson A, Mitchell C, Thain C, Mitchell-Thain R, Jones D, Trivedi PJ, Mells GF, Alrubaiy L; UK-PBC audit group. Critical shortfalls in the management of PBC: Results of a UK-wide, population-based evaluation of care delivery. JHEP Rep. 2023 Oct 16;6(1):100931. doi: 10.1016/j.jhepr.2023.100931
Journal / Source Title
JHEP Reports
DOI
10.1016/j.jhepr.2023.100931
PMID
38089546
Publisher
Elsevier