Abstract

Background/aims

The North East and North Cumbria (NENC) region of England experiences significant health inequalities in relation to alcohol, particularly in men. Early identification of liver disease can improve patient outcomes. Men aged 45-59 drinking >50 units of alcohol per week were offered a FibroScan and alcohol brief intervention (ABI) in a pilot pathway. We qualitatively evaluated the pathway to gather evidence regarding barriers, enablers acceptability.

Methods

Semi-structured interviews, developed using the Thematic Framework of Acceptability (TFA), were conducted with patients who were offered the pathway(n=12) and staff involved in pathway delivery(n=5). Interviews were analysed thematically, first using an inductive approach to code the data to generate initial themes, then a deductive approach of grouping themes under TFA domains. A Patient Involvement and Community Engagement group with lived experience supported the project.

Results

Many aspects of the pathway were acceptable, with several practical barriers identified. Perceptions of the pathway often related to how participants’ expectations were managed throughout the pathway. The drug and alcohol centre venue and alcohol brief intervention posed barriers for some participants which related to stigma. Consequently, a theme of stigma was included alongside the TFA domains due to its evident impact on participants.

Conclusions

The pilot FibroScan pathway represents an acceptable means of providing liver scanning for early identification of alcohol-related liver disease. The role of stigma must be considered in the development of alcohol related interventions, especially with regards to venue and discussion of alcohol consumption. Recommendations are made regarding future development of the pathway to utilise enablers and minimise barriers to uptake. Services should consider wider rollout.