Non-alcoholic Fatty Liver Disease in Bangladesh: Insights from Primary Care Physicians’ Knowledge, Attitudes and Practices

KAP of primary care physicians on NAFLD

Authors

  • Shakhawat Hossain Department of Gastroenterology, Rangpur Medical College, Rangpur, Bangladesh
  • Maknunnahar School of Science and Technology, Bangladesh Open University, Gazipur, Bangladesh
  • Md Masudur Rahman Khan Department of Gastroenterology, Bangladesh Medical University, Dhaka, Bangladesh
  • Mohammad Shoaib Chowdhury Department of Gastroenterology, Bangladesh Medical University, Dhaka, Bangladesh
  • Mohammad Sofiul Kadir Department of Gastroenterology National Gastroliver Institute & Hospital, Dhaka.
  • Md Sahidur Rahman Department of Gastroenterology National Gastroliver Institute & Hospital, Dhaka
  • S M Sayadat Amin Research Division, Bangladesh Medical Research Council, Mohakhali, Dhaka, Bangladesh

DOI:

https://doi.org/10.3329/bmrcb.v51i02.83206

Keywords:

nonalcoholic fatty liver disease, primary care physician, knowledge, attitude and practice

Abstract

Background: Primary care physicians (PCP) are the corner stone of non-alcoholic fatty liver disease (NAFLD) management as they are the first point where patient’s management begin. Knowledge and practice pattern of PCP reflects the overall scenario of NAFLD management in a country.

Objectives: To assess the status of current Knowledge, Attitude and Practices among Primary Care Physicians of Bangladesh in regards to NAFLD.

Methods: Thi cross-sectional survey conducted from July 2023 to December 2023. About 384 registered primary care physicians (PCP) from 20 randomly selected upazila of Rangpur divisions were included in this study. A survey questionnaire in English language was developed and administered. Continuous variables were analyzed by Student’s t test, categorical variables by the Chi square test.

Results: Among 384 participant, overall 82.8% of PCP had sound knowledge(satisfactory) regarding NAFLD diagnosis and management. This study found better attitude among 81% of physicians and approximately good attitude to the remaining 19%. Most of the physician did not counsel NAFLD patients about prognosis (70%), did not manage according to existing guidelines (93.75%), did not advise about lifestyle modification (59.6%), were not confident in dealing a NAFLD patients(62.5%) and usually did not advise for follow up(50.78%) of the patients. About thirty percent of study physicians prescribe lipid lowering agents and 29.95% prescribe ursodeoxycholic acid. Whereas, only 7.55% of them prescribed Vitamin E and 4.95% prescribed pioglitazone. Association of ‘practicing year experience’ of PCP showed that, paradoxically, physicians with 10-15 years’ experience showed significantly lower guideline adherence (c2=4.67, p=0.031) and vitamin E prescription (c2=4.92, p=0.027) compared to younger colleagues. Physicians in divisional area demonstrate significantly higher screening rates (χ2=11.27, p=0.004) and treatment confidence (χ2=8.92, p=0.012) compared to rural (thana/union) practitioners. In this study, male physicians showed significantly higher metabolic screening (χ2=8.12, p=0.004) and specialist referrals (χ2=9.45, p=0.002).

Conclusions: This study revealed that our PCP have better knowledge about NAFLD. But their practices are not adequate. That’s why, continuous medical education of clinicians on current practice guidelines for NAFLD is needed.

Bangladesh Medical Res Counc Bull 2025;51(2): 63-68

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Published

2025-11-20

Issue

Vol. 51 No. 2 (2025)

Section

Research Papers

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Copyright (c) 2025 Shakhawat Hossain, Maknunnahar, Md. Masudur Rahman Khan, Mohammad Shoaib Chowdhury, Mohammad Sofiul Kadir, Md. Sahidur Rahman, S. M. Sayadat Amin

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