Monitor patients with NAFLD in primary care annually, assessing for signs of disease progression such as advanced liver disease, hypertension, obesity, and metabolic risk factors NICE CKS.
Reassess the risk of advanced liver fibrosis every 3 years in low-risk individuals, without routine liver blood tests, and refer high-risk patients to a hepatology specialist for further assessment NICE CKS.
Use non-invasive tests such as transient elastography (Fibroscan) or the enhanced liver fibrosis (ELF) test to evaluate for advanced liver fibrosis, with a score of 10.51 or above indicating significant fibrosis NICE CKS,NICE NG49.
In cases where non-invasive tests suggest advanced fibrosis, consider specialist investigations like liver biopsy or elastography, and monitor for progression or resolution of fibrosis during follow-up NICE CKS,NICE NG49.
Reassess the person's risk factors, including metabolic profile and liver fibrosis status, at regular intervals, and adjust management accordingly NICE CKS.