Impacto das equipas de cuidados paliativos na doença hepática crónica

Abstract

Introduction: Chronic liver disease (CLD) is one of the principal causes of morbidity andmortality globally. Marked by prognostic uncertainty and an inconsistent trajectory, CLDis characterised by successive episodes of decompensation, often requiring secondarycare admission and the in majority of cases, associated with significant symptomaticburden. The complexity of CLD and this unique patient population is reliant on access tospecialist palliative care (PC) teams, and limitations in access to these PC services hassubsequently contributed to loss of symptom control and failure to formulate anappropriate care plan for optimal management. The purpose of this study is to create aprotocol that will evaluate the benefits of intervention by the PC team in provision ofcare for patients with CLD.Aims: This study will evaluate the impact of interventions carried out by the in-hospitalsupportive and palliative care team (SPCT) in the improvement of symptom control andquality of life (QoL) in patients with end-stage CLD.Methods: This prospective, 2-arm, observational study will be carried out aiming toevaluate the impact of PC team involvement in the care inpatients with end-stage CLDadmitted under the care of the Gastroenterology service. In the treatment arm, patientswill receive specialist input from the SCPT and will be followed from initial referral andadmission, including subsequent follow-up consultations during 12 months, comparedwith the control arm, where patients will receive current routine standard of care.Interventions carried out by the SCPT will focus on symptom control and communication, and efficacy of interventions will be measured using the Palliative care Outcome Scale (POS). Limitations: Limited numbers of patients may result in a reduced and smaller sample size as well as inherent difficulties in identification and referral of patients to the SCPT may limit the success of this study.Purpose and Expectations: This study aims to consolidate and reiterate the importance of PC in the management of CLD reflected in the benefits achieved in relation to symptom control and improvement in QoL in this patient population.

Date of Award	29 Nov 2021
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Manuel Luís Capelas (Supervisor)