RESUMO
GOALS: To assess awareness of nonalcoholic fatty liver disease (NAFLD) as a disease entity among individuals with and without metabolic risk factors in an outpatient clinical setting, and to evaluate interest in patient-centered education on NAFLD. BACKGROUND: NAFLD is the most common chronic liver disease in the United States with up to 30% of the adult population affected. Individuals with metabolic risk factors, particularly, insulin resistance, diabetes, and overweight/obesity, have a high prevalence of NAFLD estimated up to 70%, yet little is known about the understanding and perceptions of NAFLD in these high-risk patients. STUDY: A self-administered paper questionnaire was given to 368 adult patients presenting to an outpatient endocrinology clinic from February 2012 to October 2012. RESULTS: A total of 302 surveys were completed for a response rate of 82%. Overall, 18% of all respondents reported awareness of NAFLD. Even among patients with self-reported major risk factors for NAFLD (overweight/obese, insulin resistant, or both overweight/obese and insulin resistant), the rates of awareness of NAFLD were low (19%, 23%, and 24%, respectively). A majority of survey respondents expressed interest in receiving patient-centered education on NAFLD (73%). CONCLUSIONS: Among high metabolic risk individuals there is low awareness of NAFLD. The majority of those surveyed expressed interest in learning about NAFLD. These findings suggest opportunities to raise public awareness of NAFLD, particularly among patients at high metabolic risk, and to provide education to high-risk individuals with the goal of implementing early prevention strategies and optimizing care.
Assuntos
Complicações do Diabetes/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Hepatopatia Gordurosa não Alcoólica/psicologia , Obesidade/psicologia , Educação de Pacientes como Assunto , Adulto , Idoso , Índice de Massa Corporal , Feminino , Humanos , Resistência à Insulina , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/etiologia , Obesidade/complicações , Fatores de Risco , Inquéritos e QuestionáriosRESUMO
Osteoporosis is a common condition of impaired bone strength leading to fractures. A targeted history, physical exam, and blood work can help elucidate potentially reversible causes of low bone mass. In the neurology office, particular attention should be paid to the patient on glucocorticoids or antiepileptic medications, as these have distinct detrimental effects on bone. Patients can be risk-stratified by using the FRAX calculator, a tool that can help determine whether the patient is at sufficient risk of fracture to warrant pharmacologic therapy. Nonpharmacologic treatments such as calcium, vitamin D, and exercise should be discussed with the patient. The cornerstone of pharmacologic therapy has been treatment with bisphosphonates, but newer medications are available as well for the high-risk patient.