%0 Journal Article %A Tina Reinson %A Christopher D Byrne %A Janisha Patel %A Magdy El-Gohary %A Michael Moore %T Transient elastography in patients at risk of liver fibrosis in primary care: a follow-up study over 54 months %D 2021 %R 10.3399/BJGPO.2021.0145 %J BJGP Open %P BJGPO.2021.0145 %X Background Liver fibrosis assessment services using transient elastography are growing in primary care. These services identify patients requiring specialist referral for liver fibrosis, and provide an opportunity for recommending lifestyle change. However, there are uncertainties regarding service design, effectiveness of advice given, and frequency of follow-up.Aims To assess: a) effectiveness of standard care lifestyle advice for weight management and alcohol consumption; b) uptake for liver rescan; c) usefulness of a 4.5-year time interval of rescanning in monitoring progression of liver fibrosis.Design & setting Analysis of patient outcomes 4.5 years after first ‘liver service’ attendance that included transient elastography in five GP practices in Southampton, UK.Method Outcomes included weight, alcohol consumption, rescan uptake, time interval between scans and change in liver fibrosis stage.Results 401 participants were re-contacted. Mean ± SD wt loss was 1.2 kg ±8.4 kg (P=0.005), alcohol AUDIT grade increased by 7.8% (P=<0.001). 116/401 participants were eligible for liver rescanning. 59/116 (50.9%) agreed to undergo rescanning. Mean ± SD time interval between scans was 53.6±3.4 months. Liver fibrosis progressed from mild (≥6.0 kPa-8.1kPa) to significant fibrosis (8.2 kPa-9.6kPa) in 3.4% of patients; from mild to advanced fibrosis (9.7 kPa-13.5kPa)/cirrhosis (≥13.6 kPa) in 15.3% of patients, and did not progress in 81.3%. No baseline factors were independently associated with liver fibrosis progression at follow-up.Conclusion Rescan recall attendance and adherence to lifestyle changes needs improving. Optimum time interval between scans remains uncertain. After a mean interval of 53.6 months between scans, and with no specific predictors indicated, a substantial minority (18.7%) experienced a deterioration in fibrosis grade. %U https://bjgpopen.org/content/bjgpoa/early/2021/09/24/BJGPO.2021.0145.full.pdf