Looking after your liver for less: an approach to dietary advice in chronic liver disease to support patients experiencing food insecurity in the UK

Objective Patients with liver disease in the UK experience high rates of poverty. We explored a quality improvement project addressing the need for a patient information bundle providing dietary advice for people experiencing chronic liver disease (CLD) in the era of food insecurity in the UK. Method An initial survey of patients attending hepatology outpatient appointments was conducted to assess the utility of an information bundle and the practical requirements with 91 respondents. The information bundle was then co-produced with members of the Bristol Liver Unit Support Group, and a follow-up survey of 24 people with CLD was conducted to assess the response to its introduction. Results The initial survey indicated that there is an unmet need for pragmatic dietary advice for people with CLD, particularly in relation to those with limited resources. The follow-up survey indicated high acceptability of the information bundle, with patients commenting it provided novel and practical advice on dietary changes. Clinician feedback was that the information bundle helped to facilitate open conversations with patients about dietary changes within the context of food insecurity. Conclusion Food insecurity is a pressing issue in hepatology care. The introduction of an information bundle providing specific dietary advice in this context can support patients to explore options for their dietary needs as well as providing the foundation for constructive conversations between patients and clinicians.