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Hepatology
Original research
Looking after your liver for less: an approach to dietary advice in chronic liver disease to support patients experiencing food insecurity in the UK
  1. Ann Jane Archer1,2,
  2. Alice Lagnado3,
  3. Jennifer Phillips2,4,
  4. Sally Tilden1,
  5. Samuel Poore1,
  6. Benjamin Hayes1,
  7. Kushala W M Abeysekera1,2
  1. 1Department of Liver Medicine, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
  2. 2Population Health Science, University of Bristol, Bristol, UK
  3. 3University Hospitals Bristol NHS Foundation Trust, Bristol, UK
  4. 4Department of Gastroenterology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
  1. Correspondence to Dr Ann Jane Archer; annarcher1{at}nhs.net

Abstract

Objective Patients with liver disease in the UK experience high rates of poverty. We explored a quality improvement project addressing the need for a patient information bundle providing dietary advice for people experiencing chronic liver disease (CLD) in the era of food insecurity in the UK.

Method An initial survey of patients attending hepatology outpatient appointments was conducted to assess the utility of an information bundle and the practical requirements with 91 respondents. The information bundle was then co-produced with members of the Bristol Liver Unit Support Group, and a follow-up survey of 24 people with CLD was conducted to assess the response to its introduction.

Results The initial survey indicated that there is an unmet need for pragmatic dietary advice for people with CLD, particularly in relation to those with limited resources. The follow-up survey indicated high acceptability of the information bundle, with patients commenting it provided novel and practical advice on dietary changes. Clinician feedback was that the information bundle helped to facilitate open conversations with patients about dietary changes within the context of food insecurity.

Conclusion Food insecurity is a pressing issue in hepatology care. The introduction of an information bundle providing specific dietary advice in this context can support patients to explore options for their dietary needs as well as providing the foundation for constructive conversations between patients and clinicians.

  • LIVER
  • DIET
  • CIRRHOSIS
  • MALNUTRITION

Data availability statement

Data are available upon reasonable request.

https://doi.org/10.1136/flgastro-2024-102857

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • AJA and AL are joint first authors.

    • X @anniearcher, @KushAbey

    • Contributors All authors were involved in the information bundle design. AJA: conceptualisation, data collection, data analysis, writing—first draft, writing—revisions and editing. AL: data collection, data analysis, writing—revisions and editing. JP, ST, SP and BH: data collection, data analysis, writing—revisions and editing. ST: data collection, data analysis, writing—revisions and editing. KWMA: coneptualisation, writing—revisions and editing, supervision. KWMA is the guarantor.

    • Funding KWMA is in receipt of a National Institute for Health and Care Research funded lectureship. AJA is partly funded by the NIHR Health Protection Research Unit in Behavioural Science and Evaluation.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.