Pragmatic strategies to address health disparities along the continuum of care in chronic liver disease

Author:

Brahmania Mayur1ORCID,Rogal Shari2ORCID,Serper Marina3ORCID,Patel Arpan4ORCID,Goldberg David5ORCID,Mathur Amit6ORCID,Wilder Julius7ORCID,Vittorio Jennifer8ORCID,Yeoman Andrew9ORCID,Rich Nicole E.10,Lazo Mariana11ORCID,Kardashian Ani12ORCID,Asrani Sumeet13ORCID,Spann Ashley14ORCID,Ufere Nneka15ORCID,Verma Manisha16ORCID,Verna Elizabeth17ORCID,Simpson Dinee18ORCID,Schold Jesse D.19ORCID,Rosenblatt Russell17ORCID,McElroy Lisa20ORCID,Wadwhani Sharad I.21ORCID,Lee Tzu-Hao22ORCID,Strauss Alexandra T.23ORCID,Chung Raymond T.15ORCID,Aiza Ignacio24ORCID,Carr Rotonya25ORCID,Yang Jin Mo26ORCID,Brady Carla7ORCID,Fortune Brett E.27ORCID

Affiliation:

1. Department of Medicine, Division of Gastroenterology and Transplant Medicine, University of Calgary, Calgary, Alberta, Canada

2. Department of Medicine, Division of Gastroenterology, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA

3. Department of Medicine, Division of Gastroenterology, University of Pennsylvania, Philadelphia, Pennsylvania, USA

4. Department of Medicine, Division of Gastroenterology, University of California Los Angeles, Los Angeles, California, USA

5. Department of Medicine, Division of Gastroenterology, University of Miami, Miami, Florida, USA

6. Department of Surgery, Division of Transplant Surgery, Mayo Clinic, Phoenix, Arizona, USA

7. Department of Medicine, Division of Gastroenterology, Duke University School of Medicine, Durham, North Carolina, USA

8. Department of Pediatrics, Division of Pediatric Gastroenterology, NYU Langone Health, New York, New York, USA

9. Department of Medicine, Gwent Liver Unit, Aneurin Bevan University Health Board, Newport, Wales, UK

10. Department of Medicine, Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, Texas, USA

11. Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

12. Department of Medicine, Division of Gastrointestinal and Liver Diseases, University of Southern California, Los Angeles, California, USA

13. Department of Medicine, Division of Gastroenterology, Baylor University Medical Center, Dallas, Texas, USA

14. Department of Medicine, Division of Gastroenterology, Vanderbilt University, Nashville, Tennessee, USA

15. Department of Medicine, Liver Center, Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA

16. Department of Medicine, Einstein Healthcare Network, Philadelphia, Pennsylvania, USA

17. Department of Medicine, Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New York, New York, USA

18. Department of Surgery, Northwestern University, Chicago, Illinois, USA

19. Department of Surgery and Epidemiology, University of Colorado, Aurora, Colorado, USA

20. Department of Surgery, Duke University School of Medicine, Durham, North Carolina, USA

21. Department of Pediatrics, University of California San Francisco, San Francisco, California, USA

22. Department of Medicine, Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas, USA

23. Department of Medicine, Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland, USA

24. Department of Medicine, Liver Unit, Hospital Ángeles Lomas, Mexico City, Mexico

25. Department of Medicine, Division of Gastroenterology, University of Washington, Seattle, Washington, USA

26. Department of Medicine, Division of Gastroenterology, Catholic University of Korea, Seoul, Korea

27. Department of Medicine, Division of Hepatology, Montefiore Einstein Medical Center, Bronx, New York, USA

Abstract

Racial, ethnic, and socioeconomic disparities exist in the prevalence and natural history of chronic liver disease, access to care, and clinical outcomes. Solutions to improve health equity range widely, from digital health tools to policy changes. The current review outlines the disparities along the chronic liver disease health care continuum from screening and diagnosis to the management of cirrhosis and considerations of pre-liver and post-liver transplantation. Using a health equity research and implementation science framework, we offer pragmatic strategies to address barriers to implementing high-quality equitable care for patients with chronic liver disease.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Reference136 articles.

1. Increasing health care burden of chronic liver disease compared with other chronic diseases, 2004–2013;Asrani;Gastroenterology,2018

2. Mortality due to cirrhosis and liver cancer in the United States, 1999–2016: Observational study;Tapper;BMJ (Online),2018

3. OPTN/SRTR 2018 annual data report: Liver;Kwong;Am J Transplant,2020

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