A nurse‐led FibroScan® outreach clinic encourages socially deprived heavy drinkers to engage with liver services

Aims and objectives To determine whether a portable FibroScan® device can be an acceptable screening tool for chronic liver disease in a community alcohol support service, through recording uptake, determining apparent prevalence of undiagnosed fibrosis/cirrhosis in participants and report engagement following referral to specialist liver services of those individuals referred because of a FibroScan® reading ≥ 7.1 kilopascals (kPa). Background Alcohol‐related liver disease, including cirrhosis, is a major cause of death in the UK. Liver disease is silent and usually presents late. Socially deprived patients with alcohol‐related liver disease are a “hard to engage” population and at higher risk of death than less deprived. A FibroScan® device is a non‐invasive tool for measuring liver stiffness. A result of ≥7.1 kPa can indicate possible chronic liver disease. Design Prospective observational study. Method Individuals who self‐identified as harmful drinkers were recruited. Consented individuals attended for a liver FibroScan®. Those with a reading ≥7.1 kPa were referred to a nurse‐led liver clinic for further investigations, results of which determined referral to a liver specialist in secondary care. Participants referred were monitored for compliance over a 6‐month period. Results Seventy‐nine consented individuals participated, an uptake of 67% of those informed of the study. Of the 79 scans performed, three were unreliable leaving 76 participants. After scanning, 20/76 (26%) had a FibroScan® ≥7.1 kPa requiring referral on to the nurse‐led clinic. All 20 (100%) engaged in further assessment. Of those, 12 required onward referral to specialist services. Subsequent compliance with specialist services in this sample (n = 12) was ≥90%. Conclusion A nurse‐led FibroScan® outreach clinic encourages socially deprived drinkers to engage with liver services. Relevance to clinical practice A 67% uptake suggests a nurse‐led FibroScan® service in a community alcohol service is acceptable. High engagement gives potential for early intervention and improved health outcomes.