Review
Gastroenterology & Hepatology
Shan Shan Vijeratnam, Bridget Candy, Rachel Craig, Aileen Marshall, Patrick Stone, Joseph T. S. Low
Summary: Patients with end-stage liver disease on the liver transplant waiting list may benefit from specialist palliative care, but there are challenges in referral due to lack of clarity on criteria and patients' concerns. Limited understanding and uptake of advance care planning and treatment goals were found among patients. Further research is needed to explore how palliative care could be integrated into this clinical setting.
DIGESTIVE DISEASES AND SCIENCES
(2021)
Article
Gastroenterology & Hepatology
Roberta Jordan, Yousuf ElMokhallalati, Lynsey Corless, Michael Bennett
Summary: Patients with liver disease face difficulties in accessing end-of-life care, with a higher percentage of them dying in hospitals and receiving less specialized palliative care compared to those with malignant liver disease. Caregivers of patients with non-malignant liver disease were less likely to rate the quality of end-of-life care as outstanding/excellent.
LIVER INTERNATIONAL
(2023)
Review
Gastroenterology & Hepatology
Eric S. Orman, Amy W. Johnson, Marwan Ghabril, Greg A. Sachs
Summary: Despite the potential for hospice to improve care for those at the end of life, it is underutilized for patients with ESLD. Increasing the appropriate utilization of hospice for ESLD requires a better understanding of patient eligibility, which can be based on predictors of high short-term mortality and liver transplant ineligibility. Such hospice criteria should be data-driven and should accommodate the uncertainty faced by patients and physicians.
EXPERT REVIEW OF GASTROENTEROLOGY & HEPATOLOGY
(2021)
Article
Medicine, General & Internal
Minoh Ko, Sunghwan Kim, Sung Yun Suh, Yoon Sook Cho, In-Wha Kim, Shin Hye Yoo, Ju-Yeun Lee, Jung Mi Oh
Summary: This study evaluated the clinical outcomes of a pharmacist-led deprescribing service for terminal cancer patients. The results showed that the service effectively reduced the use of preventive medications and resolved medication-related problems. Pharmacists' interventions were well accepted.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Gastroenterology & Hepatology
Douglas N. Vanderwerken, Nicholas L. Wood, Dorry L. Segev, Sommer E. Gentry
Summary: This study estimated the survival probabilities without liver transplant for candidates with different MELD scores and IA status using real data. The research found an improvement in 90-day survival rates over the past decade and demonstrated the effectiveness of MELD in prioritizing candidates. It also showed that IA candidates have higher short-term survival rates compared to MELD 40 candidates but lower than MELD 39 candidates.
Article
Oncology
Keita Tagami, Kento Masukawa, Akira Inoue, Tatsuya Morita, Yusuke Hiratsuka, Mamiko Sato, Katsura Kohata, Noriaki Satake, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita
Summary: Appropriate timing for SPC referrals for advanced cancer patients and their families is associated with the quality of death, with findings suggesting that the appropriate timing is at the time of diagnosis or during anti-cancer treatment.
SUPPORTIVE CARE IN CANCER
(2022)
Article
Critical Care Medicine
Sreekanth R. Cheruku, Alexis Barina, Corey D. Kershaw, Kristina Goff, Joan Reisch, Linda S. Hynan, Farzin Ahmed, Donna Lee Armaignac, Love Patel, Katherine A. Belden, Margit Kaufman, Amy B. Christie, Neha Deo, Vikas Bansal, Karen Boman, Vishakha K. Kumar, Allan Walkey, Rahul Kashyap, Ognjen Gajic, Amanda A. Fox
Summary: This study, conducted in multiple centers, shows that palliative care consultation does not increase the likelihood of cardiopulmonary resuscitation (CPR) being performed at the end of life for patients with COVID-19. However, it is associated with an increased utilization of comfort care. These findings suggest that utilizing palliative care consultation at the end of life may better align the needs and values of patients with the care they receive.
Article
Health Care Sciences & Services
Amy W. Johnson, Benjamin Byriel, Jon Rubeck, Marwan Ghabril, Eric S. Orman
Summary: The study aimed to determine if implementing standardized palliative care consultation criteria would increase utilization and improve outcomes for patients with end-stage liver disease. A retrospective cohort study revealed that consults increased after implementation, and patients who received palliative care had higher completion rates of healthcare representative documentation and physician orders for scope of treatment forms. They were also more likely to be discharged to hospice services.
AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE
(2023)
Article
Nursing
Hyejin Kim, Jeonghyun Cho, JungSuk Lee
Summary: There is a significant disparity in end-of-life care practices in nursing homes in South Korea, which is associated with bed size and registered-nurse staffing. The importance of reforming nursing home-related regulations and policies is highlighted.
INTERNATIONAL JOURNAL OF NURSING STUDIES
(2022)
Article
Health Care Sciences & Services
Kanako Ichikura, Shiho Matsuoka, Hiroki Chiba, Hina Ishida, Yuko Fukase, Hanako Murase, Hirokuni Tagaya, Takashi Takeuchi, Eisuke Matsushima
Summary: This study aimed to compare the barriers faced by healthcare providers in cardiology and oncology hospitals in providing end-of-life psychiatric care to patients with heart failure (HF) and cancer, respectively. Through questionnaire survey and content analysis, it was found that there were no significant differences between healthcare providers of cardiology and oncology hospitals in the barriers they faced, but providers in cardiology hospitals particularly faced challenges related to non-cancer patients.
BMC PALLIATIVE CARE
(2023)
Article
Health Care Sciences & Services
Amy W. Johnson, Lilian Golzarri Arroyo, Neetu Mahendraker, Jack Hosty, Kurt Kroenke
Summary: This study aimed to compare outcomes in patients with end-stage liver disease (ESLD) who received opioid analgesia to those who did not and to determine risk factors for adverse events (AEs). The results showed that patients who received opioids had more liver-related complications and higher rates of anxiety, along with worse pain scores. The opioid group had higher rates of respiratory and gastrointestinal AEs, but no increase in CNS adverse events. Anxiety and disease severity were risk factors for the number of AEs, while opioid administration was not an independent risk factor. Therefore, opioids have an appropriate and reasonably safe role in alleviating pain in patients with ESLD.
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
(2023)
Article
Medicine, General & Internal
Christian Volberg, Pauline Fleck, Paula Vradelis, Astrid Morin, Martin Gschnell, Anna Elisabeth Pape
Summary: This study describes the work and problems of occupational therapists in palliative care in Germany. The findings show that there are various possible applications and approaches for occupational therapy in palliative care, and highlight the need for improving the status of occupational therapists in practice, as well as research and training in this area.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Gastroenterology & Hepatology
Branden D. Tarlow, W. Ray Kim, Ajitha Mannalithara, Paul Y. Kwo, C. Andrew Bonham, Allison Kwong
Summary: This study found that MELD 3.0 scores beyond 40 are associated with increasing waitlist mortality without adversely affecting posttransplant outcomes. Uncapping the MELD score for waitlist candidates may lead to greater survival benefits from liver transplantation.
Article
Health Care Sciences & Services
John Donlan, Nneka N. Ufere, Teresa Indriolo, Vicki Jackson, Raymond T. Chung, Areej El-Jawahri, Lara Traeger
Summary: Specialty palliative care (PC) is often misunderstood as hospice care by patients with end-stage liver disease (ESLD) and their caregivers. However, after receiving education on PC, nearly all participants advocated for early introduction of PC in ESLD care, regardless of transplant eligibility.
JOURNAL OF PALLIATIVE MEDICINE
(2021)
Article
Gastroenterology & Hepatology
Jessica P. Woolfson, Manuela Perez, Govind B. Chavhan, Fatema T. Johara, Eberhard Lurz, Binita M. Kamath, Vicky L. Ng
Summary: Sarcopenia is prevalent in 40% of children with ESLD awaiting LT, and is associated with deficient anthropometrics and the need for nutritional support before LT. Children with sarcopenia had a longer duration of PICU stay post-LT, reflecting negative outcomes linked to muscle loss. Further research is required to understand the mechanisms of sarcopenia in children with ESLD.
LIVER TRANSPLANTATION
(2021)