Nurse Led Clinics; a Novel Model of Care for Compensated Liver Cirrhosis: A Qualitative Analysis.

Ambulatory Care Facilities Humans Liver Cirrhosis / therapy Nurse-Patient Relations Nurses Practice Patterns, Nurses'

Journal

Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates
ISSN: 1538-9766
Titre abrégé: Gastroenterol Nurs
Pays: United States
ID NLM: 8915377

Informations de publication

Date de publication:
Historique:
received: 14 10 2020
accepted: 26 02 2021
pubmed: 10 8 2021
medline: 5 2 2022
entrez: 9 8 2021
Statut: ppublish

Résumé

A nurse-led cirrhosis clinic model for management of stable, compensated cirrhotic patients is practised in our unit since 2013, wherein these patients are reviewed every six months by specialist nurses in community clinics under remote supervision of hepatologists. We evaluated the experiences of patients and healthcare providers involved in the model to understand the acceptability, strengths, and limitations of the model and obtain suggestions to improve. A qualitative design using in-depth interviews was employed, followed by thematic analysis of eight patients, one attending physician both nurse and hospital clinics, four hepatologists, and three experienced specialist nurses running the nurse-led cirrhosis clinic. Patients expressed satisfaction and a good understanding of the nurse-led cirrhosis clinic, preferring it to hospital clinics for better accessibility and the unique nurse-patient relationship. Upskilling and provision of professional care in a holistic manner were appreciated by specialist nurses. The hepatologists expressed confidence and satisfaction, although they acknowledged the difference between the medical training of specialist nurses and hepatologists. The greater availability of hospital clinic time for sick patients was welcomed. Increased specialist nurse staffing, regular forums to promote specialist nurse learning, and formalization of the referral process were suggested. No adverse experiences were reported by patients or staff. The nurse-led cirrhosis clinic model for compensated liver cirrhosis was well received by patients, hepatologists, and specialist nurses. Wider implementation of the model could be considered after further investigations in other settings.

Identifiants

DOI: 10.1097/SGA.0000000000000620 PMID: 34369404
pubmed: 34369404
doi: 10.1097/SGA.0000000000000620
pii: 00001610-202201000-00004
doi:

Types de publication

Journal Article

Langues

eng

Pagination

29-42

Informations de copyright

Copyright © 2021 Society of Gastroenterology Nurses and Associates.

Déclaration de conflit d'intérêts

The authors declare no conflicts of interest.

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Auteurs

Jeyamani Ramachandran (J)

Jeyamani Ramachandran, PhD, MD, MBBS, DM, FRACP, is Consultant Hepatologist, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Sharon Lawn, PhD, is Professor, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Matilda Swee Sun Tang, MBBS, is an intern, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Anuradha Pati, SACE, is Second-Year Medical Student, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
Luisa Wigg, IBDP, is Second-Year Medical Student, College of Medicine and Dentistry, James Cook University, Douglas, Queensland, Australia.
Rachel Wundke, BNurs, is Clinical Practice Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Rosemary Mccormick, BNurs, is Clinical Practice Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Kate Muller, PhD, FRACP, is Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Billingsley Kaambwa, PhD, is Associate Professor and Head of Health Economics, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Richard Woodman, PhD, is Professor, Department of Biostatistics and Epidemiology, Flinders University, Bedford Park, South Australia.
Alan Wigg, PhD, FRACP, is Professor and Head, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.

Sharon Lawn (S)

Jeyamani Ramachandran, PhD, MD, MBBS, DM, FRACP, is Consultant Hepatologist, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Sharon Lawn, PhD, is Professor, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Matilda Swee Sun Tang, MBBS, is an intern, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Anuradha Pati, SACE, is Second-Year Medical Student, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
Luisa Wigg, IBDP, is Second-Year Medical Student, College of Medicine and Dentistry, James Cook University, Douglas, Queensland, Australia.
Rachel Wundke, BNurs, is Clinical Practice Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Rosemary Mccormick, BNurs, is Clinical Practice Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Kate Muller, PhD, FRACP, is Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Billingsley Kaambwa, PhD, is Associate Professor and Head of Health Economics, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Richard Woodman, PhD, is Professor, Department of Biostatistics and Epidemiology, Flinders University, Bedford Park, South Australia.
Alan Wigg, PhD, FRACP, is Professor and Head, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.

Matilda Swee Sun Tang (MSS)

Jeyamani Ramachandran, PhD, MD, MBBS, DM, FRACP, is Consultant Hepatologist, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Sharon Lawn, PhD, is Professor, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Matilda Swee Sun Tang, MBBS, is an intern, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Anuradha Pati, SACE, is Second-Year Medical Student, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
Luisa Wigg, IBDP, is Second-Year Medical Student, College of Medicine and Dentistry, James Cook University, Douglas, Queensland, Australia.
Rachel Wundke, BNurs, is Clinical Practice Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Rosemary Mccormick, BNurs, is Clinical Practice Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Kate Muller, PhD, FRACP, is Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Billingsley Kaambwa, PhD, is Associate Professor and Head of Health Economics, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Richard Woodman, PhD, is Professor, Department of Biostatistics and Epidemiology, Flinders University, Bedford Park, South Australia.
Alan Wigg, PhD, FRACP, is Professor and Head, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.

Anuradha Pati (A)

Jeyamani Ramachandran, PhD, MD, MBBS, DM, FRACP, is Consultant Hepatologist, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Sharon Lawn, PhD, is Professor, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Matilda Swee Sun Tang, MBBS, is an intern, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Anuradha Pati, SACE, is Second-Year Medical Student, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
Luisa Wigg, IBDP, is Second-Year Medical Student, College of Medicine and Dentistry, James Cook University, Douglas, Queensland, Australia.
Rachel Wundke, BNurs, is Clinical Practice Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Rosemary Mccormick, BNurs, is Clinical Practice Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Kate Muller, PhD, FRACP, is Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Billingsley Kaambwa, PhD, is Associate Professor and Head of Health Economics, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Richard Woodman, PhD, is Professor, Department of Biostatistics and Epidemiology, Flinders University, Bedford Park, South Australia.
Alan Wigg, PhD, FRACP, is Professor and Head, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.

Luisa Wigg (L)

Jeyamani Ramachandran, PhD, MD, MBBS, DM, FRACP, is Consultant Hepatologist, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Sharon Lawn, PhD, is Professor, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Matilda Swee Sun Tang, MBBS, is an intern, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Anuradha Pati, SACE, is Second-Year Medical Student, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
Luisa Wigg, IBDP, is Second-Year Medical Student, College of Medicine and Dentistry, James Cook University, Douglas, Queensland, Australia.
Rachel Wundke, BNurs, is Clinical Practice Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Rosemary Mccormick, BNurs, is Clinical Practice Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Kate Muller, PhD, FRACP, is Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Billingsley Kaambwa, PhD, is Associate Professor and Head of Health Economics, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Richard Woodman, PhD, is Professor, Department of Biostatistics and Epidemiology, Flinders University, Bedford Park, South Australia.
Alan Wigg, PhD, FRACP, is Professor and Head, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.

Rachel Wundke (R)

Jeyamani Ramachandran, PhD, MD, MBBS, DM, FRACP, is Consultant Hepatologist, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Sharon Lawn, PhD, is Professor, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Matilda Swee Sun Tang, MBBS, is an intern, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Anuradha Pati, SACE, is Second-Year Medical Student, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
Luisa Wigg, IBDP, is Second-Year Medical Student, College of Medicine and Dentistry, James Cook University, Douglas, Queensland, Australia.
Rachel Wundke, BNurs, is Clinical Practice Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Rosemary Mccormick, BNurs, is Clinical Practice Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Kate Muller, PhD, FRACP, is Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Billingsley Kaambwa, PhD, is Associate Professor and Head of Health Economics, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Richard Woodman, PhD, is Professor, Department of Biostatistics and Epidemiology, Flinders University, Bedford Park, South Australia.
Alan Wigg, PhD, FRACP, is Professor and Head, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.

Rosemary McCormick (R)

Jeyamani Ramachandran, PhD, MD, MBBS, DM, FRACP, is Consultant Hepatologist, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Sharon Lawn, PhD, is Professor, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Matilda Swee Sun Tang, MBBS, is an intern, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Anuradha Pati, SACE, is Second-Year Medical Student, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
Luisa Wigg, IBDP, is Second-Year Medical Student, College of Medicine and Dentistry, James Cook University, Douglas, Queensland, Australia.
Rachel Wundke, BNurs, is Clinical Practice Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Rosemary Mccormick, BNurs, is Clinical Practice Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Kate Muller, PhD, FRACP, is Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Billingsley Kaambwa, PhD, is Associate Professor and Head of Health Economics, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Richard Woodman, PhD, is Professor, Department of Biostatistics and Epidemiology, Flinders University, Bedford Park, South Australia.
Alan Wigg, PhD, FRACP, is Professor and Head, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.

Kate Muller (K)

Jeyamani Ramachandran, PhD, MD, MBBS, DM, FRACP, is Consultant Hepatologist, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Sharon Lawn, PhD, is Professor, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Matilda Swee Sun Tang, MBBS, is an intern, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Anuradha Pati, SACE, is Second-Year Medical Student, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
Luisa Wigg, IBDP, is Second-Year Medical Student, College of Medicine and Dentistry, James Cook University, Douglas, Queensland, Australia.
Rachel Wundke, BNurs, is Clinical Practice Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Rosemary Mccormick, BNurs, is Clinical Practice Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Kate Muller, PhD, FRACP, is Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Billingsley Kaambwa, PhD, is Associate Professor and Head of Health Economics, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Richard Woodman, PhD, is Professor, Department of Biostatistics and Epidemiology, Flinders University, Bedford Park, South Australia.
Alan Wigg, PhD, FRACP, is Professor and Head, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.

Billingsley Kaambwa (B)

Jeyamani Ramachandran, PhD, MD, MBBS, DM, FRACP, is Consultant Hepatologist, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Sharon Lawn, PhD, is Professor, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Matilda Swee Sun Tang, MBBS, is an intern, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Anuradha Pati, SACE, is Second-Year Medical Student, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
Luisa Wigg, IBDP, is Second-Year Medical Student, College of Medicine and Dentistry, James Cook University, Douglas, Queensland, Australia.
Rachel Wundke, BNurs, is Clinical Practice Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Rosemary Mccormick, BNurs, is Clinical Practice Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Kate Muller, PhD, FRACP, is Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Billingsley Kaambwa, PhD, is Associate Professor and Head of Health Economics, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Richard Woodman, PhD, is Professor, Department of Biostatistics and Epidemiology, Flinders University, Bedford Park, South Australia.
Alan Wigg, PhD, FRACP, is Professor and Head, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.

Richard Woodman (R)

Jeyamani Ramachandran, PhD, MD, MBBS, DM, FRACP, is Consultant Hepatologist, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Sharon Lawn, PhD, is Professor, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Matilda Swee Sun Tang, MBBS, is an intern, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Anuradha Pati, SACE, is Second-Year Medical Student, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
Luisa Wigg, IBDP, is Second-Year Medical Student, College of Medicine and Dentistry, James Cook University, Douglas, Queensland, Australia.
Rachel Wundke, BNurs, is Clinical Practice Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Rosemary Mccormick, BNurs, is Clinical Practice Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Kate Muller, PhD, FRACP, is Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Billingsley Kaambwa, PhD, is Associate Professor and Head of Health Economics, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Richard Woodman, PhD, is Professor, Department of Biostatistics and Epidemiology, Flinders University, Bedford Park, South Australia.
Alan Wigg, PhD, FRACP, is Professor and Head, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.

Alan Wigg (A)

Jeyamani Ramachandran, PhD, MD, MBBS, DM, FRACP, is Consultant Hepatologist, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Sharon Lawn, PhD, is Professor, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Matilda Swee Sun Tang, MBBS, is an intern, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Anuradha Pati, SACE, is Second-Year Medical Student, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
Luisa Wigg, IBDP, is Second-Year Medical Student, College of Medicine and Dentistry, James Cook University, Douglas, Queensland, Australia.
Rachel Wundke, BNurs, is Clinical Practice Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Rosemary Mccormick, BNurs, is Clinical Practice Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Kate Muller, PhD, FRACP, is Consultant, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Billingsley Kaambwa, PhD, is Associate Professor and Head of Health Economics, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Richard Woodman, PhD, is Professor, Department of Biostatistics and Epidemiology, Flinders University, Bedford Park, South Australia.
Alan Wigg, PhD, FRACP, is Professor and Head, Hepatology and Liver Transplant Unit, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.

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