Palliative care in liver disease: what does good look like?
cirrhosis
end of life
Journal
Frontline gastroenterology
ISSN: 2041-4137
Titre abrégé: Frontline Gastroenterol
Pays: England
ID NLM: 101528589
Informations de publication
Date de publication:
2020
2020
Historique:
received:
04
07
2019
revised:
08
08
2019
accepted:
11
08
2019
entrez:
19
5
2020
pubmed:
19
5
2020
medline:
19
5
2020
Statut:
epublish
Résumé
The mortality rate from chronic liver disease in the UK is rising rapidly, and patients with advanced disease have a symptom burden comparable to or higher than that experienced in other life-limiting illnesses. While evidence is limited, there is growing recognition that care of patients with advanced disease needs to improve. Many factors limit widespread provision of good palliative care to these patients, including the unpredictable trajectory of chronic liver disease, the misconception that palliative care and end-of-life care are synonymous, lack of confidence in prescribing and lack of time and resources. Healthcare professionals managing these patients need to develop the skills to ensure effective delivery of core palliative care, with referral to specialist palliative care services reserved for those with complex needs. Core palliative care is best delivered by the hepatology team in parallel with active disease management. This includes ensuring that discussions about disease trajectory and advance care planning occur alongside active management of disease complications. Liver disease is strongly associated with significant social, psychological and financial hardships for patients and their carers; strategies that involve the wider multidisciplinary team at an early stage in the disease trajectory help ensure proactive management of such issues. This review summarises the evidence supporting palliative care for patients with advanced chronic liver disease, presents examples of current best practice and provides pragmatic suggestions for how palliative and disease-modifying care can be run in parallel, such that patients do not miss opportunities for interventions that improve their quality of life.
Identifiants
pubmed: 32419913
doi: 10.1136/flgastro-2019-101180
pii: flgastro-2019-101180
pmc: PMC7223359
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
218-227Informations de copyright
© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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