Integrated Model for Patient-Centered Advanced Liver Disease Care

Clin Gastroenterol Hepatol. 2020 May;18(5):1015-1024. doi: 10.1016/j.cgh.2019.07.043. Epub 2019 Jul 26.

Abstract

Advanced liver disease (AdvLD) is a high-risk common condition with a progressive, highly morbid, and often fatal course. Despite effective treatments, there are substantial shortfalls in access to and use of evidence-based supportive and palliative care for AdvLD. Although patient-centered, chronic illness models that integrate early supportive and palliative care with curative treatments hold promise, there are several knowledge gaps that hinder development of an integrated model for AdvLD. We review these evidence gaps. We also describe a conceptual framework for a patient-centered approach that explicates key elements needed to improve integrated care. An integrated model of AdvLD would allow clinicians, patients, and caregivers to work collaboratively to identify treatments and other healthcare that best align with patients' priorities.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Caregivers
  • Chronic Disease
  • Humans
  • Liver Diseases*
  • Palliative Care
  • Patient-Centered Care*