998 Can You Treat Me Now? An Evaluation of Patient-Centered Resources Discussing Fatty Liver Treatment Options

INTRODUCTION: Non-alcoholic fatty liver disease (NAFLD) is an increasingly prevalent liver disorder estimated to occur in up to 46 percent of the U.S. adult population. Management includes optimization of weight, diabetes, dyslipidemia, and vitamin E in selected patients. However, patients may opt to self-treat NAFLD based on internet available information, including therapies such as vitamin E which may be potentially harmful if taken in excess. This study evaluated internet accessible information addressing the treatment choices and management of NAFLD. METHODS: The search terms “fatty liver” identified the first 100 websites in the Google search engine. Exclusion criteria for this study included non-accessible websites, video postings without transcripts, or articles discussing veterinary topics. The remaining websites were classified by target audience: patient or professional. Statistical analysis using a two-tailed Fisher’s Exact Test was performed with a P-value set at <0.05. RESULTS: 88 websites met inclusion criteria with 52 (59.1%) targeting patients and 36 (40.9%) for medical professionals. 71 (80.7%) provided management recommendations, with significantly more patient websites discussing treatment (P = 0.02) compared to professional sites. Patient sites more often discussed lifestyle modifications (P = 0.02) as therapy. There was no significant difference in the discussion of diabetic agents, vitamin E, statins, or bariatric surgery between patient and professional websites. Patient websites preferentially discussed treatment benefits compared to possible side effects (P < 0.0001). Patient-clinician shared decision-making was emphasized on patient websites (57.7%; P < 0.01) and websites focused on management strategies (50.7%; P = 0.01). CONCLUSION: Individuals are increasingly using online resources to obtain information about NAFLD management. While patient websites were more likely to discuss lifestyle modification, patient and professional websites did not specifically focus on other potential intervention. Only half the websites recommended shared decision-making, more often occurring in patient websites and in sites addressing management. Across all sites, the benefits rather than potential risks of NAFLD treatment were more frequently discussed. It is important that online websites addressing NAFLD offer treatment options that are evidence-based, promote safe interventions, and encourage discussion with a provider.