Defining comprehensive models of care for NAFLD

Jeffrey V. Lazarus, Quentin M. Anstee, Hannes Hagström, Kenneth Cusi, Helena Cortez-Pinto, Henry E. Mark, Michael Roden, Emmanuel A. Tsochatzis, Vincent Wai Sun Wong, Zobair M. Younossi, Shira Zelber-Sagi, Manuel Romero-Gómez, Jörn M. Schattenberg

Research output: Contribution to journalReview articlepeer-review


Non-alcoholic fatty liver disease (NAFLD) is now the leading cause of chronic liver disease globally. Despite the increased demand placed on health-care systems, little attention has been given to the design and implementation of efficient and effective models of care for patients with NAFLD. In many health-care settings, no formal pathways exist and, where pathways are in place, they are often not standardized according to good practices. We systematically searched the peer-reviewed literature with the aim of identifying published examples of comprehensive models of care that answered four key questions: what services are provided? Where are they provided? Who is offering them? How are they coordinated and integrated within health-care systems? We identified seven models of care and synthesized the findings into eight recommendations nested within the ‘what, where, who and how’ of care models. These recommendations, aimed at policy-makers and practitioners designing and implementing models of care, can help to address the increasing need for the provision of good practice care for patients with NAFLD.

Original languageEnglish
Pages (from-to)717-729
Number of pages13
JournalNature Reviews Gastroenterology and Hepatology
Issue number10
StatePublished - Oct 2021

Bibliographical note

Funding Information:
to the data search and analysis and for her input during the early drafting of the manuscript. J.V.L. acknowledges support to ISGlobal from the Spanish Ministry of Science, Innovation and Universities through the “Centro de Excelencia Severo Ochoa 2019-2023” Programme (CEX2018-000806-S), and from the Government of Catalonia through the “CERCA Programme”.

Funding Information:
J.V.L. reports grants, personal fees and other from AbbVie, MSD and Gilead Sciences, and personal fees from CEPHEID, GSK, Intercept, and Janssen outside the submitted work. Q.M.A. reports grants, personal fees and other from Allergan/ Tobira, Genfit SA, Pfizer Ltd.; other from E3Bio, Eli Lilly & Company Ltd., Galmed, Grunenthal, Imperial Innovations, Inventiva, Janssen, MedImmune, NewGene, Raptor Pharma, NGMBio, Madrigal, Servier, EcoR1, 89Bio, Altimmune, Axcella, Blade, BNN Cardio, Celgene, Cirius, CymaBay, Genentech, HistoIndex, Indalo, IQVIA, Metacrine, North Sea Therapeutics, Poxel, Terns, Viking Therapeutics, and PathAI; personal fees and other from Gilead, BMS, and Novo Nordisk; grants and other from Intercept Pharma Europe Ltd., Novartis Pharma AG, and AstraZeneca; personal fees from Kenes; and grants from Abbvie, GSK, and Glympse Bio outside the submitted work. K.C. reports other from Allergan, AstraZeneca, BMS, Merck, Janssen, Coherus, Pfizer, and Genentech, grants from Gilead, Prosciento, Boehringer Ingelheim, Cirius Therapeutics, Novartis, Echosens, Poxel, Zydus, Novo Nordisk, and Eli Lilly, and grants and other from Inventiva outside the submitted work. H.C.-P. reports personal fees from Intercept, Genfit and Promethera Bioscience outside the submitted work. M.R. reports personal fees from Eli Lilly, Poxel S.A. Société, Boehringer-Ingelheim Pharma, Terra Firma, Sanofi US, Servier Labatories, PROSCIENTO, Inc., Novo Nordisk, Fishawack Group, Novartis Pharma GmbH, Target RWE, Gilead Sciences, Kenes Group, Bristol-Myers Squibb, Intercept Pharma, Inventiva, AstraZeneca, and Allergan GmbH outside the submitted work. E.A.T. reports personal fees from Gilead, Intercept, GMP Orphan and Pfizer outside the submitted work. V.W.-S.W. reports personal fees from 3V-BIO, AbbVie, Allergan, Boehringer Ingelheim, Bristol-Myers Squibb, Echosens, Gilead Sciences, Hanmi Pharmaceutical, Intercept, Merck, Novartis, Novo Nordisk, Perspectum Diagnostics, Pfizer, ProSciento, Sagimet Biosciences, TARGET PharmaSolutions, and Terns, and grants from Gilead Sciences outside the submitted work. M.R.-G. reports grants from INTERCEPT and GILEAD-SCIENCES, personal fees from SHIONOGI, ALFA-WASSERMAN, PROSCIENTO, KALEIDO, Novo Nordisk, MSD, BMS, Allergan, Boehringer-Ingelheim, Zydus, Intercept Pharma and Gilead Science outside the submitted work. J.M.S. reports personal fees from BMS, Boehringer Ingelheim, Echosens, Genfit, Gilead Sciences, Intercept Pharmaceuticals, Madrigal, Novartis, Pfizer, and Roche, grants from Gilead Sciences, Endra Life Sciences Inc., and Siemens Healthcare GmbH., and other from Falk Foundation MSD Sharp & Dohme GmbH outside the submitted work. All other authors declare no competing interests.

Publisher Copyright:
© 2021, Springer Nature Limited.

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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