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. 2022 Sep;76(3):819-853.
doi: 10.1002/hep.32378. Epub 2022 Apr 22.

AASLD Practice Guidance: Palliative care and symptom-based management in decompensated cirrhosis

Shari S Rogal  1   2 , Lissi Hansen  3 , Arpan Patel  4   5 , Nneka N Ufere  6 , Manisha Verma  7 , Christopher D Woodrell  8   9 , Fasiha Kanwal  10   11
Affiliations

AASLD Practice Guidance: Palliative care and symptom-based management in decompensated cirrhosis

Shari S Rogal et al. Hepatology. 2022 Sep.
No abstract available

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Conflict of interest statement

CONFLICT OF INTEREST

The opinions expressed in this article are the authors’ own and do not reflect the views of the National Institutes of Health or the United States government.

Figures

FIGURE 1
FIGURE 1
Domains of palliative care. The eight domains of palliative care, as defined by the National Consensus Project Clinical Practice Guidelines for Quality Palliative Care Guidelines, 4th Edition. Reference: Ferrell et al. 2018 include spiritual, cultural, social, psychological, ethical, physical, care at the end of life, and processes of care (e.g., ACP).[14] This figure also includes patients, families, and the multidisciplinary team as central to palliative care
FIGURE 2
FIGURE 2
Steps in Advance Care Planning (ACP). ACP is an iterative process that involves working with patients and their families to identify and document their preferences for care. This graphic provides a roadmap for engaging in ACP
FIGURE 3
FIGURE 3
Structured frameworks for goals-of-care conversations. (A) Ask-Tell-Ask is a simple approach that can be used to deliver bad news. (B) The R.E.M.A.P. Framework is a step-wise approach to engaging patients in more-complex decision making. (C) Best-case worst-case provides a way to frame difficult choices, such as the choice to pursue a transplant. References: ©2021 VitalTalk. All rights reserved. VitalTalk content is for informational, educational, and noncommercial use only.[89] Zimmermann et al. 2020; Schwarze et al. 2020; Back et al. 2005; and Childers et al. 2017.[–95] Readers can learn more at https://www.vitaltalk.org/
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References

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    1. Radbruch L, De Lima L, Knaul F, Wenk R, Ali Z, Bhatnaghar S, et al. Redefining palliative care—a new consensus-based definition. J Pain Symptom Manage. 2020;60(4):754–64. 10.1016/j.jpainsymman.2020.04.027 - DOI - PMC - PubMed
    1. Verma M, Tapper EB, Singal AG, Navarro V. Nonhospice palliative care within the treatment of end-stage liver disease. Hepatology. 2020;71(6):2149–59. 10.1002/hep.31226 - DOI - PMC - PubMed
    1. Tandon P, Walling A, Patton H, Taddei T. AGA clinical practice update on palliative care management in cirrhosis: expert review. Clin Gastroenterol Hepatol. 2021;19(4):646–56.e3. 10.1016/j.cgh.2020.11.027 - DOI - PubMed
    1. Verma M, Bakitas MA. Creating effective models for delivering palliative care in advanced liver disease. Curr Hepatol Rep. 2021;20(2):43–53. 10.1007/s11901-021-00562-0 - DOI - PMC - PubMed

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