A group of UK NIHR liver disease experts has released a call to action for new research on chronic liver disease (CLD) focusing on multi-causality, multimorbidity, and health inequalities.
The National Institute for Health and Care Research (NIHR) is the British government’s major funder of clinical, public health, social care and translational research.
Deaths caused by chronic liver disease (CLD) have increased by a staggering 400% in the past four decades.
It is the third leading cause of premature death among people of working age. About 40 people in the UK die every day due to CLD. While trends in cancer and cardiovascular deaths have decreased in recent years the trend has been the opposite for CLD.
While CLD is mostly preventable, the disease is often diagnosed too late. By the time of diagnosis, patients are already suffering multiple complications and reduced quality of life. Managing these conditions places a heavy burden on liver services and the wider healthcare system. Therefore, it is imperative that the growing CLD burden is addressed now.
Causes of chronic liver disease
CLD is caused by many factors.
The use of alcohol products and obesity are the two leading risk factors for the disease.
The effects are compounded by wider determinants of health, including deprivation, smoking, and poor nutrition. These factors are disproportionately observed in CLD patients and also lead to many other diseases.
Most CLD patients experience multiple other diseases such as diabetes, cardiovascular disease, and cancer.
CLD and other multiple diseases affect deprived communities far more than others. These communities also face health inequalities and they are underserved in opportunities to receive treatment services.
There is a need for new research on CLD that looks into the multiple causes of the disease and multi-morbidity. Research must also focus on high deprivation areas. Successful research can lead to earlier diagnosis and prevention of CLD and minimization of multi morbidity.
Collaboration among researchers in different fields including hepatology, gastroenterology, behavioral science, primary care, mental health, nutrition, diabetes, cardiology and oncology is key for successful CLD research.
Keeping this in mind, NIHR launched a cross-specialty, multidisciplinary CLD project led by its Hepatology National Specialty Group. Working groups were formed in the following four key areas:
- Early detection of multimorbidity/liver disease.
- Behavioral interventions for alcohol and obesity.
- Pharmacological interventions for CLD and associated conditions.
- Physical interventions for CLD and associated conditions.
These groups are reviewing existing research and developing collaborative research proposals to answer questions in CLD which are still unanswered.
Additionally, NIHR has released a new funding call for cross-specialty, multi-disciplinary research on CLD. This new funding call is commissioning new research of varying size and scope to help establish and grow partnerships, networks, and collaborations in liver disease research.
To ensure the best possible outcome from the funding, partnerships must:
- actively include areas and communities previously under-served by research and where the clinical need is greatest;
- have community-based participant recruitment, from secondary care.
NIHR liver disease experts Lynsey Corless, William Rosenberg, and Karina Mahiouz are calling on researchers to get involved in these new NIHR initiatives.
These NIHR initiatives have the potential to improve NHS liver services and the wider healthcare system and to shape treatment and prevention strategies of the future. The new CLD research through these initiatives will ultimately benefit the UK public and the healthcare system in the long run.