Supportive and palliative care needs in advanced non-malignant liver disease: systematic review

Haire, Ellen, Mann, Mala, Yeoman, Andrew, Atkinson, Clea, Wright, Mark and Noble, Simon ORCID: https://orcid.org/0000-0001-5425-2383 2024. Supportive and palliative care needs in advanced non-malignant liver disease: systematic review. BMJ Supportive & Palliative Care 10.1136/spcare-2024-004785

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Abstract

Advanced cirrhosis confers a significant symptom burden and has a 50% 2-year mortality rate in those with decompensated disease. There is increasing demand for supportive and palliative care (SAPC) for these patients, yet no consensus on the best model of delivery. It is necessary to identify the needs of such patients and their carers, and evaluate whether they are being met.A literature search was conducted using key words pertaining to adult patients with liver cirrhosis and their SAPC needs. Study quality was assessed and findings grouped by theme. 51 full texts were selected for inclusion, 8 qualitative studies, 33 quantitative studies, 7 systematic reviews, 2 mixed methods studies and 1 Delphi methods. Key findings were grouped into three main themes: SAPC needs, access to SAPC and models of care.Patients with cirrhosis have significant psychological and physical symptom burden with many unmet needs. These data failed to identify the best service model of care. The impact of specialist palliative care (SPC) referral was limited by small numbers and late referrals. With the majority of studies conducted in the USA, it is unclear how well these findings translate to other healthcare systems. Comparison between hepatology led services and SPC was limited by inconsistent outcome measures and prevented pooling of data sets. These data also had limited evaluation of patient-reported outcome measures. We propose the development of a core outcome set to ensure consistent and meaningful evaluation of the SAPC needs of patients with advanced non-malignant liver cirrhosis.

Item Type:	Article
Date Type:	Published Online
Status:	Published
Schools:	Medicine Marie Curie Palliative Care Research Centre (MCPCRC)
Publisher:	BMJ Publishing Group
ISSN:	2045-435X
Funders:	Marie Curie Cancer Care core grant
Date of Acceptance:	21 March 2004
Last Modified:	16 Dec 2024 12:45
URI:	https://orca.cardiff.ac.uk/id/eprint/174375

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