Self-Management Interventions for Chronic Liver Disease: A Scoping Review

Background: High rates of obesity have led to increases in chronic liver disease (CLD) and fatty liver disease. Cognitive-behavioral self-management interventions may be successful options for improving lifestyle and outcomes for CLD. Our objective was to summarize evidence on such self-management interventions for a range of CLD severity. Methods: We searched databases for research evidence on cognitive-behaviorally-based self-management interventions for a range of obesity-related CLD severity. Interventions that incorporated health technology (IT) were also reviewed. Scoping review methods followed published guidelines. Results: Of 574 studies initially identified, 11 studies met defined criteria. Most were RCTs, and all found evidence of improved outcomes. Outcomes focused on weight loss, BMI, and liver function metrics. Four studies included a health IT component. Five studies were pilots and reported that feasibility was established. Only two pilot studies were conducted in North America. Conclusions: There was growing evidence supporting self-management interventions as effective for promoting lifestyle change and improving outcomes in people with CLD. Utilization of technology may facilitate wider intervention access and is potentially a less costly approach. Future research is needed to examine the cost-effectiveness of cognitive-behaviorally based self-management interventions for CLD and compare the efficacy of in-person versus virtual self-management programs.