Integrating palliative care into management of advanced liver disease
Research type
Research Study
Full title
Integration of palliative care into the management of patients with advanced liver disease
IRAS ID
193380
Contact name
Hazel Woodland
Contact email
Sponsor organisation
University of Bristol
Duration of Study in the UK
1 years, 7 months, 1 days
Research summary
Deaths from liver disease have increased dramatically in the United Kingdom over the past 20 years. Liver disease disproportionately affects young patients and those from socio-economically deprived populations, and is the third commonest cause of working age death in the UK.
Advanced liver disease causes a range of unpleasant symptoms towards the end of life including itch, vomiting blood, fluid in the abdomen (ascites), jaundice, muscle weakness and confusion. Because liver disease can sometimes be cured (e.g by stopping drinking alcohol or liver transplantation) the point at which aggressive medical care becomes futile is more difficult to identify than in other diseases such as cancer.
Despite evidence demonstrating the benefit of palliative and supportive care in advanced liver disease such care is rarely accessed. Research from the Royal Free Hospital demonstrated only 19% of patients assessed unsuitable for liver transplantation were referred to palliative care, on average only 4 days before death.
Our research involves patients with advanced liver disease alongside their relatives and carers. Through interviewing patients and relative and carer interviews we will investigate the patient and family experience of advanced stage liver disease within the NHS. We will also investigate the impact of an early palliative and supportive care intervention in patients with advanced liver disease, in terms of its effect on mood, symptoms and quality of life.
We will combine this information with wider epidemiological research looking at how UK patients with liver disease access healthcare in the last year of their life, and the current barriers to referring patients with liver disease to specialist palliative care in England.Ultimately we aim to design an easily transferable clinical framework through which palliative and supportive care can be integrated into the ongoing active management of patients with advanced liver disease.
REC name
South Central - Hampshire B Research Ethics Committee
REC reference
16/SC/0041
Date of REC Opinion
25 Feb 2016
REC opinion
Further Information Favourable Opinion