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. 2018 May;32(5):919-929.
doi: 10.1177/0269216318760441. Epub 2018 Mar 8.

Palliative care for people with advanced liver disease: A feasibility trial of a supportive care liver nurse specialist

Barbara Kimbell  1 , Scott A Murray  1 , Heidi Byrne  2 , Andrea Baird  2 , Peter C Hayes  2 , Alastair MacGilchrist  2 , Anne Finucane  3 , Patricia Brookes Young  4 , Ronan E O'Carroll  5 , Christopher J Weir  6 , Marilyn Kendall  1 , Kirsty Boyd  1
Affiliations

Palliative care for people with advanced liver disease: A feasibility trial of a supportive care liver nurse specialist

Barbara Kimbell et al. Palliat Med. 2018 May.

Abstract

Background: Liver disease is an increasing cause of death worldwide but palliative care is largely absent for these patients.

Aim: We conducted a feasibility trial of a complex intervention delivered by a supportive care liver nurse specialist to improve care coordination, anticipatory care planning and quality of life for people with advanced liver disease and their carers.

Design: Patients received a 6-month intervention (alongside usual care) from a specially trained liver nurse specialist. The nurse supported patients/carers to live as well as possible with the condition and acted as a resource to facilitate care by community professionals. A mixed-method evaluation was conducted. Case note analysis and questionnaires examined resource use, care planning processes and quality-of-life outcomes over time. Interviews with patients, carers and professionals explored acceptability, effectiveness, feasibility and the intervention.

Setting/participants: Patients with advanced liver disease who had an unplanned hospital admission with decompensated cirrhosis were recruited from an inpatient liver unit. The intervention was delivered to patients once they had returned home.

Results: We recruited 47 patients, 27 family carers and 13 case-linked professionals. The intervention was acceptable to all participants. They welcomed access to additional expert advice, support and continuity of care. The intervention greatly increased the number of electronic summary care plans shared by primary care and hospitals. The Palliative care Outcome Scale and EuroQol-5D-5L questionnaire were suitable outcome measurement tools.

Conclusion: This nurse-led intervention proved acceptable and feasible. We have refined the recruitment processes and outcome measures for a future randomised controlled trial.

Keywords: Liver failure; care planning; feasibility trial; generalist palliative care; nurse specialist; palliative care; supportive care.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Figures

Figure 1.
Figure 1.
Components and delivery process of the intervention.
Figure 2.
Figure 2.
Flowchart of patient recruitment.
See this image and copyright information in PMC

References

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