{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:59:12Z","timestamp":1791561552440,"version":"4.3.4"},"reference-count":28,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,8,10]],"date-time":"2024-08-10T00:00:00Z","timestamp":1723248000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Gilead Science Inc.","award":["IN-EU-989-5753"],"award-info":[{"award-number":["IN-EU-989-5753"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Background: Despite its high prevalence and impact on health, metabolic dysfunction-associated steatotic liver disease (MASLD) is inadequately addressed in European primary care (PC), with a large proportion of cases going undiagnosed or diagnosed too late. A multi-country European research consortium led a project to design and evaluate a patient-centered, integrated model for MASLD screening, diagnosis, and linkage to specialty care for European PC settings. Based on the lessons from this project, the latest research evidence, and existing guidelines for the management of MASLD, we sought to develop a set of practice recommendations for screening, referral, and management of MASLD in PC. Methods: The Rand\/UCLA modified Delphi panel method, with two rounds, was used to reach consensus on practice recommendations. The international panel consisted of experts from six countries, representing family medicine, gastroenterology, hepatology, cardiology, and public health. Initially, fifteen statements were drafted based on a synthesis of evidence from the literature and earlier findings from our consortium. Prior to the consensus meeting, the statements were rated by the experts in the first round. Then, in a hybrid meeting, the experts discussed findings from round one, adjusted the statements, and reassessed the updated recommendations in a second round. Results: In round one, there was already a high level of consensus on 10 out of 15 statements. After round 2, there were fourteen statements with a high degree of agreement (&gt;90%). One statement was not endorsed. The approved recommendations addressed the following practice areas: risk screening and diagnosis, management of MASLD\u2013lifestyle interventions, pharmacological treatment of MASLD\/MASH, pharmacological treatment for co-morbidity, integrated care, surgical management, and other referrals to specialists. Conclusions: The final set of 14 recommendations focuses on increasing comprehensive care for MASLD in PC. The recommendations provide practical evidence-based guidance tailored to PC practitioners. We expect that these recommendations will contribute to the ongoing discussion on systematic approaches to tackling MASLD and supporting European PC providers by integrating the latest evidence into practice.<\/jats:p>","DOI":"10.3390\/diseases12080180","type":"journal-article","created":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T05:19:38Z","timestamp":1723439978000},"page":"180","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Practice Recommendations for the Management of MASLD in Primary Care: Consensus Results"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9324-2839","authenticated-orcid":false,"given":"Christos","family":"Lionis","sequence":"first","affiliation":[{"name":"Clinic of Social and Family Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Papadakis","sequence":"additional","affiliation":[{"name":"Clinic of Social and Family Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marilena","family":"Anastasaki","sequence":"additional","affiliation":[{"name":"Clinic of Social and Family Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eftihis","family":"Aligizakis","sequence":"additional","affiliation":[{"name":"Health Center of Kandanos, Crete, 73004 Kandanos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Foteini","family":"Anastasiou","sequence":"additional","affiliation":[{"name":"4th Local Health Team-Municipality Practice and Academic Unit of Heraklion, Crete, 71303 Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7527-4714","authenticated-orcid":false,"given":"Sven","family":"Francque","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Antwerp University Hospital, University of Antwerp, 2650 Edegem, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irini","family":"Gergianaki","sequence":"additional","affiliation":[{"name":"Clinic of Social and Family Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8095-7707","authenticated-orcid":false,"given":"Juan Manuel","family":"Mendive","sequence":"additional","affiliation":[{"name":"La Mina Primary Health Care Centre, IDIAP Jordi Gol, 08003 Barcelona, Spain"},{"name":"European Society for Primary Care Gastroenterology, London E1 6HU, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1888-3430","authenticated-orcid":false,"given":"Maria","family":"Marketou","sequence":"additional","affiliation":[{"name":"Clinic of Cardiology, University Hospital of Heraklion, Crete, 70013 Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8780-476X","authenticated-orcid":false,"given":"Jean","family":"Muris","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, 6229 Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Spilios","family":"Manolakopoulos","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3518-4060","authenticated-orcid":false,"given":"Georgios","family":"Papatheodoridis","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Medical School, National and Kapodistrian University of Athens, General Hospital of Athens \u201cLaiko\u201d, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Samonakis","sequence":"additional","affiliation":[{"name":"Clinic of Gastroenterology & Hepatology, University Hospital of Heraklion, 70013 Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanouil","family":"Symvoulakis","sequence":"additional","affiliation":[{"name":"Clinic of Social and Family Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7922-7491","authenticated-orcid":false,"given":"Ioanna","family":"Tsiligianni","sequence":"additional","affiliation":[{"name":"Clinic of Social and Family Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/S0140-6736(21)01701-3","article-title":"The EASL-lancet liver commission: Protecting the next generation of Europeans against liver disease complications and premature mortality","volume":"399","author":"Karlsen","year":"2021","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1966","DOI":"10.1097\/HEP.0000000000000520","article-title":"A multisociety Delphi consensus statement on new fatty liver disease 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