The aim of this qualitative study is to explore and identify the expectations, perceptions, attitudes, needs, and knowledge related to the management of metabolic dysfunction-associated steatohepatitis (MASH) in patients diagnosed with this condition, before and after their participation in the MASH-Cardiovascular Programme at Hospital de la Santa Creu i Sant Pau, Barcelona.

The main research question is:

What expectations, attitudes, needs, and perceptions do patients with MASH participating in the MASH-Cardiovascular Programme exhibit before and after the intervention?

Participants will undergo two semi-structured interviews: one prior to, and one following, their involvement in the MASH-Cardiovascular Programme at Hospital de Sant Pau i la Santa Creu, Barcelona.

Inclusion Criteria:

• Patients who voluntarily agree to participate in the MASH-Cardiovascular Programme.
• Patients followed in the outpatient hepatology/gastroenterology clinic at Hospital de Sant Pau with a diagnosis of MASH and fibrosis stage F2-F4.
• Patients aged between 18 and 75 years.
• Patients with a BMI ≥ 27 kg/m².
• Patients who consent to participate in the study-specific interviews.

Exclusion Criteria:

• Patients who do not agree to participate in the study-specific interviews.
• Patients meeting exclusion criteria of the MASH-Cardiovascular Programme:
• Patients with decompensated liver cirrhosis.
• Patients who are vegetarians or have dietary habits/preferences that prevent adherence to standard-of-care nutritional guidelines.
• Patients with moderate-to-severe alcohol consumption (>20 g/day for women and >40 g/day for men).
• Patients with an eGFR < 30 mL/min.
• Patients with malnutrition.
• Patients with type 1 diabetes or other forms of diabetes.
• Patients who are candidates for bariatric surgery.
• Patients with active malignancy.
• Patients with advanced or unstable heart failure.
• Patients with eating disorders or severe psychiatric illness.
• Patients currently enrolled in another clinical trial.
• Pregnant women or women planning to become pregnant.

The semi-structured interview includes a specific gender identity question: Which gender do you identify with?

• Woman
• Man
• Non-binary
• Prefer not to answer

The study population will consist of individuals diagnosed with MASH who are referred to the multidisciplinary MASH-Cardiovascular Programme at Hospital de la Santa Creu i Sant Pau in Barcelona.