P75 A community-based pilot for proactive screening of high-risk groups for chronic liver disease can lead to sustained healthcare engagement of people diagnosed with cirrhosis

<h3>Background and Aims</h3> ‘Alright My Liver?’ was developed in collaboration with service users to screen for advanced liver fibrosis from alcohol, viral hepatitis and metabolic syndrome in the South West of England. The service aims to reach the most high-risk populations for liver disease and those likeliest to experience health inequalities. This study aims to report on markers of engagement by those the service identified as having cirrhosis. <h3>Method</h3> Screening events were co-located with drug and alcohol services, primary care services in areas with a high index of deprivation, weight management events and with Caafi Health, an organization providing health outreach to black and ethnic minority communities in the region. Clients identified with advanced fibrosis were booked into hepatology clinic and ultrasound with an offer of funded transport and telephone reminders. Routine data has been analysed here, with index of multiple deprivation calculated based on postcode where recorded, and set to 1 if the patient was living in a prison or hostel. <h3>Results</h3> Of 3191 people screened for liver disease, 228 had liver stiffness measurement (LSM) &gt;11.5 kPa and were referred for further assessment. This cohort was ethnically diverse relative to the local population, 78% white British or other (baseline population 84%). The cohort median index of multiple deprivation (IMD) decile was 3, with 20% reporting experience of homelessness. Attendance at first liver ultrasound was 89% (n = 152/170), rising to 93% (n = 158/170) including those who attended when offered a second attempt. Attendance at 6-month surveillance ultrasound was 76% (n = 41/54), rising to 87% (n = 47/54) including those upon second attempt. For outpatient clinic, 80% (n = 106/132) attended on first opportunity, rising to 84% (n = 111/132) when including those who attended on a second invitation. These compare favourably to baseline attendance of 80% locally for both clinic and ultrasound for hepatology patients. A chi-squared test of independence revealed no association between first clinic attendance and AUDIT-C score ≤4 or ≥5 (X² (1, N = 75) = 0.788, p = .374) or IMD decile ≤5 or ≥6 (X² (1, N = 127) = 3.238, p = .072) <h3>Conclusion</h3> The pilot service is successful in engaging a patient group with their ongoing care despite barriers to attendance including substance dependence, unstable housing and socioeconomic deprivation. This proactive engagement approach could have broader utility in hepatology to support an underserved population and reduce emergency admissions.