Akshaya Institute of Pharmacy, Tumkur, India.
The liver is the largest internal organ vital for metabolism, detoxification nutrient storage, and bile production. Common liver diseases include hepatitis, fatty liver disease (alcoholic and non- alcoholic), cirrhosis and liver cancer. Liver disease arises from alcohol, viruses, fat build-up or genetics. The present study was planned to assess Knowledge, attitude and awareness among liver disease participants. To assess Knowledge, Attitude and Awareness among Liver Disease participants. A cross-sectional observational study was undertaken for a three-month period, Data of our study was collected on the basis of Knowledge, Attitude Questionnaires. A total number of 260 participants in Tumkur region, 150 were selected as community basis and 110 were selected on college basis. In community basis 61 participants were aged about 18-28 shows 40.66% major respondents. In college basis 80 participants were aged about 18-20 shows 72.72%. They are also distributed social habits like 5.7% were smokers & 11.5% were both smokers and alcoholic. Through this study we concluded that among community basis and college basis, the college basis has better knowledge. The clinical pharmacist plays a crucial role in educating the patients regarding disease and drugs. The study highlights the need for conducting awareness programme regards life style modification and liver disease management among the participants.
Chronic liver disease (CLD):
It is defined as a progressive decline in liver function lasting more than six months, affecting the synthesis of clotting factors and other essential proteins, the detoxification of harmful metabolic substances, and the excretion of bile.
CLD is a continuous process involving inflammation, damage, and regeneration of the liver parenchyma, ultimately resulting in fibrosis and cirrhosis.[1]
Cirrhosis and its complications are becoming a leading cause of death in India, according to current data. Cirrhosis and liver cancer are mostly caused by hepatitis B and C, as well as alcoholic and non- alcoholic liver diseases.
Managing these conditions presents numerous challenges, including limited resources, a lack of hepatologists and healthcare facilities, cultural differences, reliance on untested and unproven traditional medicines and herbal supplements, a lack of universal education and awareness of disease transmission, and a higher prevalence of poverty and malnutrition.[2]
Types of Liver Disease:
ALCOHOLIC FATTY LIVER DISEASE [AFLD]:[3]
It refers to a group of conditions that begin with fatty liver, proceed to alcoholic hepatitis, and eventually leads to alcoholic cirrhosis, the most severe and permanent form of liver destruction caused by alcohol consumption.
There are three histologic phases of alcoholic liver disease
Etiology: Alcohol abuse, Alcoholic cirrhosis, Viral hepatitis, Obesity, High fat diet, Histological damage.
Signs and Symptoms: Nausea and vomiting, Abdominal pain, Loss of appetite, Increased thirst, Yellowish of eyes, Weakness, Fever, Confusion, Mood swings.
Diagnosis: Physical examination, Laboratory tests, Liver biopsy, Emphysema, Alpha-1 antitrypsin deficiency, Ascending cholangitis.
Treatment:
Pharmacological treatment
Non-Pharmacological treatment
Fig 01: Alcoholic Fatty Liver Disease
NON-ALCOHOLIC FATTY LIVER DISEASE [NAFLD]:
Etiology: Obesity, Type 2 diabetes mellitus, Dyslipidaemias, Metabolic syndrome, Genetic inheritance, Side effects of medications.
Signs and Symptoms: Nausea, Vomiting, Jaundice, Pruritis, Memory impairment, Loss of appetite, Gynecomastia
Diagnosis: Clinical evaluation, Imaging, Laboratory tests, sometimes liver biopsy [5]
Treatment:
Pharmacological treatment
Non-Pharmacological treatment
Fig 02: Non- Alcoholic Fatty Liver Disease
Aim and Objectives:
Aim:
A study to assess the Knowledge, Attitude and Awareness regarding Liver Disease in Tumkur region.
Objectives:
MATERIALS AND METHODS:
Study Site:
The study will be carried out in community of Tumkur region.
Duration of Study:
The study will be undertaken for a three-month period.
Study Design:
A cross-sectional observational study.
Proposed Sample size:
260
Source of Data:
Study Criteria:
|
Inclusion Criteria |
Exclusion Criteria |
|
|
Study Procedure:
Material Used:
Methods:
RESULTS:
A three-month cross-sectional observational study was conducted among chronic liver disease participants from rural and college setting in the Tumkur region. A total number of 260 participants are participated during the study period. Out of 260 participants 150 participants are selected on rural basis [77(51.33%) were males and 73(48.66%) were females] and 110 participants are selected on college basis [33(30%) were males and 77(70%) were females].
Distribution of participants according to gender on rural basis:
|
Gender |
Total no. of participants(N=150) |
Percentage |
|
Male |
77 |
51.33% |
|
Female |
73 |
48.66% |
Distribution of participants according to gender on college basis:
|
Gender |
Total no. of participants(N=110) |
Percentage |
|
Male |
33 |
30% |
|
Female |
77 |
70% |
Distribution of participants according to age groups on rural basis:
Among 150 rural-based participants, age ranges from 18 years to participants above 50 years. They are categorised into 4 groups, among these groups majority of the participants were from age range 18-28 years i.e., 61 participants (40.66%) and only 25 participants (16.66%) were from age between 40-50 years.
|
Age (years) |
No. of participants (N=150) |
Percentage |
|
18-28 |
61 |
40.66% |
|
29-39 |
37 |
24.66% |
|
40-50 |
25 |
16.66% |
|
51 & above |
27 |
18% |
Distribution of participants according to age group on college basis:
Among 110 college-based participants, age ranges from 18 years to 28 years. They are categorised into 2 groups, among these majority of the participants were from age range 18-20 years i.e., 80 participants (72.72%) and 30 participants (27.27%) were from age range between 21-28 years.
|
Age (years) |
No. of participants (N=110) |
Percentage |
|
18-20 |
80 |
72.72% |
|
21-28 |
30 |
27.27% |
Distribution of participants based on social history:
Distribution of 260 participants based on social history was in 3 categories namely Smoker, Smoker and Alcoholic, and Alcoholic. Among 260 participants, 190 (73.07%) were neither smokers nor alcoholics and 30 (11.53%) were found to be smokers and alcoholics.
|
Category |
No. of participants (N=260) |
Percentage |
|
Smoker |
15 |
5.76% |
|
Smoker & Alcoholic |
30 |
11.53% |
|
Alcoholic |
25 |
9.61% |
|
Nil |
190 |
73.07% |
Assessment of Knowledge:
Among 260 participants, in Assessment of Knowledge based Questionnaires majority of the participants showed [YES] response for Drinking too much alcohol can cause AFLD? (73.07%) and only (19.23%) of participants showed [YES] response for Do you think you are at risk of NAFLD?
|
SR. NO |
Questions |
% of Yes response |
% of No response |
% of Don’t know response |
|
1 |
Have you heard about NAFLD before today? |
48.84% |
45.76% |
5.38% |
|
2 |
Abdominal pain is a common symptom of NAFLD? |
56.93% |
20% |
23.07% |
|
3 |
Yellow pigmentation of skin and eyes (jaundice) is a common symptom of AFLD? |
48.07% |
27.69% |
24.23% |
|
4 |
Drinking too much alcohol can cause AFLD? |
73.07% |
17.30% |
9.61% |
|
5 |
Eating too much added sugar can cause NAFLD? |
45% |
28.07% |
26.92% |
|
6 |
Eating too much fat can cause AFLD? |
48.84% |
33.07% |
18.07% |
|
7 |
Being obese or overweight is a risk factor for NAFLD? |
53.84% |
22.30% |
23.84% |
|
8 |
Smoking is the risk factor for NAFLD? |
47.69% |
22.84% |
23.46% |
|
9 |
Do you think NAFLD can have dangerous conditions? |
56.53% |
20.38% |
23.07% |
|
10 |
Do you think you are at a risk of NAFLD? |
19.23% |
55% |
25.76% |
Assessment of Attitude:
Among 260 participants, in Assessment of Attitude based Questionnaires majority the of participants showed [YES] response for Do you think obesity cause NAFLD? (57.30%) and only (28.84%) participants showed [YES] response for Do you think hypertension affects NAFLD?
|
SR. NO |
Questions |
% of Yes response |
% of No response |
% of Don’t know response |
|
1 |
Would you undergo for medical screening for NAFLD? |
34.23% |
50% |
15.76% |
|
2 |
Do you think obesity cause NAFLD? |
57.30% |
24.23% |
18.46% |
|
3 |
Do you think diabetes cause NAFLD? |
43.07% |
30% |
26.92% |
|
4 |
Do you think high level of cholesterol cause NAFLD? |
53.07% |
30.76% |
16.15% |
|
5 |
Do you think hypertension affects NAFLD? |
28.84% |
33.46% |
37.69% |
|
6 |
Do you think exercise affect the avoidance of NAFLD? |
53.84% |
5.38% |
20.76% |
|
7 |
Do you think exercise affects the avoidance of NAFLD? |
48.07% |
25.38% |
26.53% |
|
8 |
Do you think people with chronic liver disease feel about having disease? |
42.69% |
23.07% |
34.23% |
|
9 |
Do you refer patients of NAFLD gastroenterologist? |
35% |
30% |
35% |
|
10 |
Do you think NAFLD major health problem? |
55.38% |
19.61% |
25% |
Comparison of YES response between Assessment of Knowledge & Attitude Questionnaires:
YES, response is compared between both Assessment of Knowledge and Assessment of Attitude Questionnaires. In these 49.04% participants showed response for Assessment of Knowledge Questionnaire and only 45.49% participants showed response for Assessment of Attitude Questionnaires.
DISCUSSION:
Liver disease, particularly alcoholic fatty liver disease (AFLD) and non-alcoholic fatty liver disease (NAFLD), has become a major global health burden. AFLD is mainly associated with chronic alcohol consumption, whereas NAFLD is closely linked to lifestyle factors such as obesity, unhealthy diet, and physical inactivity. The increasing prevalence of NAFLD, even among younger individuals, is a growing concern. Treatment approaches for these conditions are divided into pharmacological and non-pharmacological strategies. Although drug therapies are being developed, lifestyle modification through diet control, weight management, and regular exercise remains the most effective and sustainable option. Integrating modern medical therapies with traditional practices, including Nutraceuticals and Ayurveda, may offer new opportunities for holistic management.
Knowledge, Attitude, and Awareness (KAA) studies help to assess how well a population understands a health condition, their attitudes towards it, and their practices in managing it. In the context of liver disease, such studies guide healthcare professionals and policymakers in designing effective interventions and educational programs. A cross-sectional observational study was conducted in Tumkur region with 260 participants. Out 260 participants majority participants showed that 73.07% recognized alcohol as cause of AFLD, but only 19.23% felt at risk for NAFLD for Assessment of Knowledge bases Questionnaires and 57.30% recognized obesity can cause NAFLD, but only 28.84% participants think hypertension affects NAFLD. Although many participants understood symptoms and the importance of checkups, adherence to regular medication and monitoring was still low.
CONCLUSION
Liver disease is a significant and growing public health challenge worldwide, affecting millions of people due to both alcoholic and non-alcoholic causes. It often progresses from simple fatty liver to advanced stages such as cirrhosis and liver failure, emphasizing the importance of early detection and timely treatment. Life style modification, including a healthy diet, regular physical activity, reduced alcohol consumption, and proper weight management, remains the cornerstone of prevention. Public health initiatives, patient education, and access to appropriate medical care also play a vital role in reducing the overall disease burden. By integrating clinical advances with community-level awareness programs, better health outcomes can be achieved for individuals at risk or already affected. Clinical pharmacist plays a crucial role in guiding patients about liver disease, medication safety, and lifestyle practices, making patient education an essential part comprehensive care. Bad adopting a healthy lifestyle, people can significantly reduce their risk of developing liver diseases and maintain overall well-being. In the Tumkur region, understanding the public’s knowledge, attitude, and awareness towards liver disease is essential for designing effective health strategies. Assessing these factors helps identify gaps in awareness, misconceptions, and preventive practices. Enhancing community education in Tumkur can empower individual to recognize early symptoms, seek timely care, and adopt healthier behaviours.
REFERENCES
Akshitha K P, Umme Salma, Hima P M, Sanjay Pattar, Tejas Kumar V, Dr. R S Meghasri, Understanding the Knowledge, Attitude and Awareness of the Public Towards Liver Disease in Tumkur Region, Int. J. of Pharm. Sci., 2025, Vol 3, Issue 12, 199-208. https://doi.org/10.5281/zenodo.17779867
10.5281/zenodo.17779867
