Introduction Alcohol misuse is the major cause of the increase in deaths from liver disease in the UK,¹ particularly in Scotland² and particularly in areas of social deprivation. Liver disease usually presents late, with advanced liver disease and cirrhosis often asymptomatic.³ Patients with alcohol misuse in areas of social deprivation are a “hard to reach” population. This study assessed the feasibility of using a portable Fibroscan® to measure transient elastography (TE), a non-invasive method of assessing hepatic fibrosis, as a screening tool within a community alcohol support service.

The study monitored the uptake of a Fibroscan® in individuals accessing one community alcohol support service in a deprived area; determined the apparent prevalence of undiagnosed fibrosis/cirrhosis in participants over a 6 month period; and monitored engagement following referral to specialist liver services of those individuals with TE > 7 kPa.

Methods Numbered research information packs were issued on request to individuals who self-identified as harmful drinkers. Consented individuals with a TE > 7 kPa were referred to a nurse-led service within the community service for further tests; results of which determined onward referral to a liver specialist. Participants were monitored for compliance with appointments and follow-up interventions.

Results 118 research packs issued with 79 participants: (67%) uptake. 3 unreliable Fibroscan® results (n = 76). 20 (26%) participants had a reading >7 kPa requiring referral to nurse led service. 12 (16%) with indications of significant liver disease requiring onward referral to liver specialist including 5 (7%) indicative of cirrhosis.19/20 (95%) participants requiring referral to nurse led service attended for further investigations.11/12 (92%) participants requiring onward referral to specialist services attended initial appointment.

Conclusion A 67% uptake suggests a nurse led Fibroscan® service in a community alcohol service is acceptable. Early indications show a high compliance with liver services offering potential for early intervention and improved health outcomes.

References 1 British Association for the Study of the Liver and British Society of Gastroenterology 2009. The National Plan for Liver Services. A time to act: improving liver health and outcomes in liver disease.

2 Scottish Public Health Observatory 2015. Public Health Information for Scotland.

3 Williams R, et al. Addressing liver disease in the UK: a blueprint for attaining excellence in health care and reducing premature mortality from lifestyle issues of excess consumption of alcohol, obesity, and viral hepatitis. Lancet. 2014;384:1953–1997.

Disclosure of Interest None Declared