Liver Disease JSNA

Evidence base

This section provides links and a brief summary of a robust evidence base. For example, peer-reviewd studies, systematic revies, evaluations of interventions and best practice guidelines from national sources.

Issue number 1 = highest priority
1	Source	Children’s Liver Disease Foundation
	Title incl. web link	Liver Disease A guide for young people LD-a-guide-for-young-people-1.pdf
	Summary	Outlines causes such as alcohol misuse, obesity and viral hepatitis. It notes that liver disease often has no symptoms until advanced stages like cirrhosis. The guide covers: Health choices (e.g. alcohol, drugs, tattoos, contraception) Emotional wellbeing Transitioning to adult care Support networks.
	Source	NICE
	Title incl. web link	Liver disease Overview \| Liver disease \| Quality standards \| NICE Overview \| Non-alcoholic fatty liver disease (NAFLD): assessment and management \| Guidance \| NICE
	Summary	Covers identifying, assessing and managing chronic liver disease in children, young people and adults including cirrhosis. The NG49 guideline includes: Identification of children and young people with advanced liver fibrosis Lifestyle and pharmacological interventions Referral pathways to tertiary care.
2	Source	House of Commons Library
	Title incl. web link	Health inequalities in liver disease and liver cancer Health inequalities in liver disease and liver cancer - House of Commons Library
	Summary	Alcohol misuse and obesity are key risk factors for developing liver disease and liver cancer, and there are significant links between health inequalities and incidence of both. Those living in the most deprived areas of the country are most adversely affected by conditions of the liver. In areas experiencing the greatest levels of deprivation the rate of premature deaths from liver disease is almost four times higher than the least deprived areas. There are also clear geographical differences in liver disease hospitalisation and mortality rates with, in general, rates being higher in the North of England, compared to London and the South of England.
	Source	Office for Health Improvement and Disparities
	Title incl. web link	Liver disease: applying All Our Health Liver disease: applying All Our Health - GOV.UK
	Summary	Guidance suggests: Early detection and prevention in primary care Addressing social determinants like poverty, education and housing Focus on working-age adults, where liver disease is a top cause of death. At community level it suggests: Screening and brief intervention for alcohol is effective and cost-effective People who are alcohol dependent should be screened for cirrhosis and fibrosis which will increase the number of early diagnoses and allow more time for intervention Encouraging people who have diabetes, high blood pressure or high cholesterol (those at-risk of liver disease) to speak to their GP about having a liver function check Ensuring all high-risk groups are immunised against hepatitis A and B as per Green Book schedule.
3	Source	NICE
	Title incl. web link	Drug misuse prevention: targeted intervention Overview \| Drug misuse prevention: targeted interventions \| Guidance \| NICE
	Summary	Focuses on targeted interventions for vulnerable groups and includes skills training, information provision and venue-based outreach. Recommendations: Delivering drug misuse prevention activities as part of existing services Assessing whether someone is vulnerable to drug misuse Providing skills training for children and young people who are vulnerable to drug misuse Providing information to adults who are vulnerable to drug misuse Providing information about drug use in settings that people who use drugs or are at risk of using drugs may attend.
	Source	British Liver Trust
	Title incl. web link	Alcohol and liver disease Alcohol and liver disease - British Liver Trust
	Summary	Not everyone who drinks too much alcohol will develop liver disease. The risk is higher for people who have another type of liver condition. And for people who have a BMI in the overweight or obese range. The liver can repair itself if alcohol intake is reduced early. Tools such as the Love Your Liver screener can be used to assess risk. Provides UK alcohol guidelines as reference and contact details for alcohol services.