HepHospital: A Pilot Trial of a Hepatology Home Hospital Intervention for Patients With Advanced Liver Disease

Launched by MASSACHUSETTS GENERAL HOSPITAL · Jan 12, 2022

Keywords

ClinConnect Summary

The HepHospital trial is looking at a new way to provide care for people with advanced liver disease, particularly those with cirrhosis, by offering treatment at home instead of in the hospital. This program aims to help patients manage their symptoms, like fluid buildup in the abdomen, while allowing them to stay in a comfortable environment. The trial is not yet recruiting participants, but it will focus on adults aged 18 and older who are receiving care at Massachusetts General Hospital and have a stable condition when admitted.

To be eligible for the trial, patients must have a confirmed diagnosis of cirrhosis and be experiencing symptoms that require hospital treatment. They should also have access to a phone or the internet and live in a specific area near the hospital. However, certain factors may exclude individuals, such as having severe confusion related to liver disease or being in critical condition. If selected, participants can expect to receive personalized care at home, making it easier for them to cope with their illness while still getting the support they need.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Adult patients ≥ 18 years old with diagnosis of cirrhosis based on histology, radiology, and/or elastography presenting to the emergency department or inpatient general medicine service
• 2. Patients must have one of the following:
• • 1. Ascites (requiring diuretics or serial large volume paracenteses)
• • 2. Hepatic hydrothorax (requiring diuretics)
• • 3. Hepatic encephalopathy (requiring medications)
• • Exclusion Criteria: All existing MGB home hospital criteria apply, with the following taking precedent for this specific condition
• • 1. History of solid organ transplantation
• • 2. On hemodialysis
• • 3. MELD score \> 20
• • 4. Score \<10 on Simplified Animal Naming Test (S-ANT1)
• • 5. Current admission for hemodynamically significant GI bleeding or alcohol withdrawal
• • 6. Require routine administration of controlled substances
• • 7. Those deemed ineligible based on the MGH Home Hospital, inpatient medicine or hepatology clinician evaluation