Personalized feedback, positive reinforcement aids NAFLD patients
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Patients with non-alcoholic fatty liver disease benefited from encouragement to complete a low-energy diet even if there were no adherence issues with intervention plans, according to results published in BMJ Open Gastroenterology.
“We conducted a qualitative interview study involving patients with clinically significant NAFLD who participated in a [low-energy diet (LED)] that aimed to initiate and maintain 10% weight loss,” Jadine Scragg, MSci, of the Newcastle National Institute for Health Research Biomedical Research Centre, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom, and colleagues wrote. “Specifically, our qualitative study aimed to identify factors associated with uptake, engagement and adherence to the LED intervention. In relation to adherence, we aimed to identify mediating factors that were both barriers and facilitators, including ways in which participants overcame barriers to adhere to the LED.”
Scragg and colleagues identified 23 patients with NAFLD and enrolled them in a low-energy diet intervention. Patients were individually interviewed and their transcripts assessed.
Results showed of the 23 patients, 14 achieved 10% weight loss or greater, 18 achieved 7% or greater and 19 achieved 5% or greater. Investigators reported on six themes generated from the information.
“A desire to achieve rapid weight loss to improve liver health and prevent disease progression was the most salient facilitator to engagement,” the researchers wrote. “Early and significant weight loss, accountability to clinicians and regular appointments with personalized feedback were facilitators to engagement and adherence. The desire to receive positive reinforcement from a consultant was a frequently reported facilitator to adherence. Practical and emotional support from friends and family members was critically important outside of the clinical setting.”
According to researchers, a barrier to adherence and completion of the intervention included irregular working patterns that prevented patients from attending appointments.
“Overall, patients found the intervention easier than anticipated to adhere to and rewarding — that is, it exceeded their expectations,” Scragg and colleagues wrote. “While barriers were identified, further research is required in a larger, more diverse group of individuals with NAFLD to explore motivators, facilitators and barriers in more detail to develop effective strategies to elicit lifestyle behavior change in clinical practice.”
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