A community based Liver Service in vulnerable adults
Research type
Research Study
Full title
Non-invasive detection, stratification and treatment of chronic liver disease in vulnerable elderly adults in the community
IRAS ID
170687
Contact name
Sumita Verma
Contact email
Sponsor organisation
Brighton and Sussex University Hospital
Duration of Study in the UK
1 years, 11 months, 31 days
Research summary
The main causes of liver scarring in England are alcohol excess, viral infections such as hepatitis C and obesity. The main risk factor for hepatitis C is substance misuse including injecting drug use. In early stages the liver scarring is reversible, though if not treated can lead to severe irreversible scarring (cirrhosis). Increasing age is an important risk factor for more severe liver scarring, though reasons fro this are unknown. Vulnerable elderly adults are often homeless with high prevalence of both alcohol and substance misuse and therefore at high risk of liver scarring. The key is to detect liver scarring early, enabling timely treatment (stopping alcohol, getting hepatitis C therapy). Though most vulnerable elderly engage with their General Practitioner they do not attend hospital appointments thus delaying this treatment.
We have recently started a successful community based liver service at a substance misuse centre in Brighton. We are now therefore providing the same service at the Brighton Homeless Healthcare comprising finger prick blood testing for viruses, assessment of alcohol and substance use, a simple painless liver scan (Fibroscan) to assess for liver scarring and hepatitis B vaccination. Those identified as having chronic liver disease/positive hepatitis C test will be offered standard of care treatment at the primary care practice. We are also keen to assess mechanisms for more aggressive liver scarring in the elderly
The research aspect of the study involves evaluation of this service by collection of routine clinical data. Additionally , to study liver scarring in the elderly, an additional four tablespoons of blood will be taken for research purposes to assess for chemicals and cells ( such as T lymphocytes) that may contribute to this liver scarring. Results of the research blood may provide early information that might inform future research.
REC name
South Central - Hampshire B Research Ethics Committee
REC reference
15/SC/0112
Date of REC Opinion
24 Mar 2015
REC opinion
Further Information Favourable Opinion