LiverPAL: A Trial of Inpatient Palliative Care for Patients With Advanced Liver Disease

Launched by MASSACHUSETTS GENERAL HOSPITAL · Aug 11, 2023

Keywords

ClinConnect Summary

The LiverPAL trial is studying how early palliative care can help hospitalized patients with advanced liver disease feel better and improve their quality of life. Palliative care is a type of medical support that focuses on relieving symptoms and providing comfort for people dealing with serious illnesses, rather than just treating the disease itself. The goal of this trial is to see if bringing in palliative care early in the hospital stay can help with things like physical comfort, emotional well-being, and communication about health issues.

To participate in this trial, patients must be hospitalized and diagnosed with advanced liver disease, specifically cirrhosis, and have experienced certain complications in the past six months, such as fluid buildup or confusion. They should be able to understand English. Caregivers, such as family members or friends who help the patients, can also take part if they are over 18 and can communicate in English. Participants in the study can expect to receive additional support during their hospital stay and will be asked to share their experiences through questionnaires. This trial is currently recruiting participants, and it aims to improve the overall care for those facing advanced liver disease.

Gender

ALL

Eligibility criteria

• Patient Inclusion Criteria:
• 1. Hospitalized patient with a diagnosis of advanced liver disease, defined as cirrhosis with one of the following (new or ongoing) within the prior six months from date of consent:
• • Ascites (requiring diuretics or serial large volume paracenteses)
• • Spontaneous bacterial peritonitis
• • Hepatic hydrothorax (requiring diuretics)
• • Variceal bleed (with one or more occurrences)
• • Overt hepatic encephalopathy (requiring medications)
• • 2. Ability to comprehend English
• Patient Exclusion Criteria:
• • 1. Prior history of liver transplantation
• • 2. Have uncontrolled hepatic encephalopathy, cognitive impairment, psychiatric disorder or other comorbid condition which the primary medical, hepatology, and/or transplant surgery teams believes prohibits the ability to provide informed consent
• • 3. Current or recent (within 5 years of receiving curative cancer treatment) history of extrahepatic malignancy (excluding non-melanoma skin cancer)
• • 4. Presence of hepatocellular carcinoma beyond Milan criteria
• • 5. Are already receiving hospice care
• • 6. Receive a score of \<10 on the Simplified Animal Naming Test
• • Caregiver Inclusion Criteria
• • 1. Adult caregiver (≥ 18 years of age)
• • 2. A relative or friend identified by the patient upon whom the patient relies for help and who likely is to be present in-person during hospitalizations or clinic appointments, or willing to participate by phone
• • 3. Ability to comprehend English and can complete questionnaires
• • Caregiver Exclusion Criteria
• • 1. Inability to comprehend English