Exploring the Role of Social Determinants of Health in autoimmune liver disease – a pilot study within the European Reference Network on hepatological diseases

Background: Social Determinants of Health (SDOH) are conditions in which people grow, work, and age. Studies highlight the influence of SDOH on the development and progression of various chronic diseases.

Aim: To explore the relation between SDOH and quality of care, treatment and outcome parameters of autoimmune liver diseases (AILD)

Methods: An international multicentre cross-sectional patient-directed questionnaire is distributed among adults with AILD between October 2024 and January 2025. questionnaire comprises of established instruments covering sociodemographics, income, education, job and food insecurity, housing, early childhood development, social support, access to health services, and treatment and progression of AILD.

Results: After 14 days, 364 patients from 6 European countries answered the questionnaire. 13% of the patients had primary sclerosing cholangitis, 43% had autoimmune hepatitis, 36% had primary biliary cholangitis, and 8% had variant syndromes. 79% were female, most participants were between 50-60 years old. Around 7% of participants screened positive for food insecurity. Meanwhile, 57% reported paying for liver medication despite health insurance, and 47% for additional private health insurance. 13% reported having liver cirrhosis, and 2% had undergone liver transplantation. Hospitalizations during the past year were reported by 8% of participants, while 68% reported normalization of liver blood tests.

Discussion: Data collection will be completed by January 2025. Regression models will be employed to analyse the association between SDOH and AILD. Results may foster prospective studies.

Publication History

Article published online:
20 January 2025