TY - JOUR
T1 - A Pilot Study of a Palliative Care Service Embedded in a Hepatology Clinic at a Large Public Hospital
AU - van Zyl, Carin
AU - Storms, Aaron D.
AU - van Deen, Welmoed
AU - Cardenas, Valeria
AU - Ellis, Robin
AU - Flores, Alicia
AU - Donovan, John
AU - Chu, Lily
AU - Patel, Tanu
AU - Enguidanos, Susan
N1 - Funding Information:
This study was funded by a grant from the California
Health Care Foundation, under grant no. 19511. Valeria
Cardenas is supported by the National Institute on Aging
of the National Institutes of Health under award number
T32AG000037.
PY - 2022/12/26
Y1 - 2022/12/26
N2 - Background: End-stage liver disease (ESLD) patients carry heavy symptom burdens and risk receiving aggressive and sometimes unwanted care at end of life. Palliative care (PC), which aims to alleviate symptoms and facilitate goal-concordant care in serious illness, may offer substantial benefits for ESLD patients but is not widely provided.Objectives: To assess the impact of PC integrated within hepatology (PCIH) services on health care utilization, advance care planning (ACP), and hospice enrollment.Design: We compared patients who received PCIH (n = 55) to a retrospective cohort (n = 57) receiving usual care in an outpatient hepatology clinic.Setting/Subjects: From June 2016 to November 2017, we enrolled patients receiving care in a U.S. public hospital clinic who met the following inclusion criteria: (1) ESLD with a Model for End-Stage Liver Disease score >= 20, (2) hepatology approval for PC referral, and (3) at least one advanced complication of ESLD.Measurements: We assessed patient demographics, clinical information, health care insurance status, health care utilization, completion of psychosocial assessments, and ACP using two-sided Fisher's exact test and Mann-Whitney U tests.Results: Patients receiving PCIH more frequently had goals of care discussions (87.3% vs. 21.2% p
AB - Background: End-stage liver disease (ESLD) patients carry heavy symptom burdens and risk receiving aggressive and sometimes unwanted care at end of life. Palliative care (PC), which aims to alleviate symptoms and facilitate goal-concordant care in serious illness, may offer substantial benefits for ESLD patients but is not widely provided.Objectives: To assess the impact of PC integrated within hepatology (PCIH) services on health care utilization, advance care planning (ACP), and hospice enrollment.Design: We compared patients who received PCIH (n = 55) to a retrospective cohort (n = 57) receiving usual care in an outpatient hepatology clinic.Setting/Subjects: From June 2016 to November 2017, we enrolled patients receiving care in a U.S. public hospital clinic who met the following inclusion criteria: (1) ESLD with a Model for End-Stage Liver Disease score >= 20, (2) hepatology approval for PC referral, and (3) at least one advanced complication of ESLD.Measurements: We assessed patient demographics, clinical information, health care insurance status, health care utilization, completion of psychosocial assessments, and ACP using two-sided Fisher's exact test and Mann-Whitney U tests.Results: Patients receiving PCIH more frequently had goals of care discussions (87.3% vs. 21.2% p
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=eur_pure&SrcAuth=WosAPI&KeyUT=WOS:000905257400001&DestLinkType=FullRecord&DestApp=WOS
U2 - 10.1089/jpm.2022.0438
DO - 10.1089/jpm.2022.0438
M3 - Article
C2 - 36577037
SN - 1096-6218
JO - Journal of Palliative Medicine
JF - Journal of Palliative Medicine
ER -