A structured web-based approach is just as beneficial as an in-person effort for patients with non-alcoholic fatty liver disease (NAFLD) to make lifestyle changes, researchers have found.
Between 2010 and 2015, researchers analyzed 716 consecutive non-alcoholic fatty liver disease cases (mean age, 52; type 2 diabetes, 33%). Patients either participated in motivational interviewing and group-based intervention (GBI) (five weekly meetings, n = 438) or a web-based intervention (WBI) that included interactive games as well as learning and motivational tests (n = 278). The target weight loss was 10%. At baseline, the GBI and WBI cohorts had similar body mass index (BMI) (mean, 33 kg/m2).
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Both groups made lifestyle changes and BMI decreased by nearly two points. The 10% goal was met by 20% of the WBI cohort and 15% of the GBI cohort, a difference researchers did not consider significant. Liver enzymes and fatty liver index were reduced in both groups, and fibrosis was stable or decreased similarly in both groups.
Since WBI did not prove to be less impactful than GBI, researchers said it may be suitable for younger or busier patients, or those who do not live near a liver unit.
“Lifestyle changes are pivotal for the treatment of NAFLD,” said lead researcher Giulio Marchesini, MD, “Alma Mater” University, Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, Bologna, Italy. “The use of web-based education tools in the management of non-communicable diseases has long been suggested, considering the huge number of cases at risk and patients’ needs. Web-based programs might help maintain contact between patients and therapists, since the majority of cases are in an age range in which job constraints make it difficult to use a systematic face-to-face or group approach.”
The study concluded: “The study shows that, following a structured motivational approach, a web-based, interactive intervention coupled with six-month face-to-face meetings is not inferior to a standard group-based intervention with respect to weight loss, adherence to healthy diet and habitual physical activity, normalization of liver enzymes, and stable surrogate markers of fibrosis.”