S2541 Improving Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) Screening and Documentation in Internal Medicine Resident Clinics: Impact of Educational Interventions

Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) has a global prevalence of approximately 25% and is expected to increase parallel with rising rates of obesity and type 2 diabetes mellitus. In 2023, AASLD guidelines emphasized the role of primary care providers (PCPs) in screening for MASLD and ruling out advanced fibrosis using the Fibrosis-4 (FIB-4) index, which has a high negative predictive value. A survey conducted in our primary care clinic (PCC) found that although 15% of internal medicine residents screened for MASLD, only 7% felt comfortable using the FIB-4 index, and 15.4% routinely counseled patients about the condition. This study aims to increase awareness and improve screening practices for MASLD within our PCC. Methods: We included patients aged ≥18 years who were seen in the PCC and had type 2 diabetes mellitus (HbA1c ≥7%) or morbid obesity (BMI ≥35 with hypertension or hyperlipidemia) during the pre-intervention period (Oct 2023-Mar 2024) and the post-intervention period (Jun-Nov 2024). Exclusions were chronic liver disease or alcohol use disorder. The intervention (Apr–May 2024) included didactic sessions, clinic huddles, reminder emails, and the addition of MASLD screening to the general screening dot phrase bundle in the Electronic Health Record (EHR). Outcomes included MASLD and medical management documentation. Data were analyzed using t-tests and chi-square/Fisher’s exact tests, with P value < 0.05 considered statistically significant. Results: A total of 557 patients were included (pre- vs post-intervention: 296 vs 261). Demographics and comorbidities were similar between groups. African American patients comprised 86.3% of the pre- vs 84.9% of the post-intervention group (P = 0.97), and non-Hispanic ethnicity comprised 95.7% of pre- vs 94.8% of post-intervention (P = 0.61). MASLD documentation was 0% pre- vs 16.0% post-intervention (P < 0.001). Medical management, including lifestyle counseling and hepatology referrals, was documented in 7.1% pre- vs 16.5% post-intervention (P < 0.001). Conclusion: Our study underscores the positive impact of a targeted educational intervention on improving MASLD documentation and increasing awareness among internal medicine residents. These findings highlight the critical role of PCPs in the early detection and risk stratification of MASLD, reinforcing the importance of integrating focused training and EHR-based tools into routine primary care practice to enhance long-term patient outcomes.