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New research into end of life care for people with liver disease

Research published today has highlighted limitations in the care provided to people with advanced liver disease who are in the last year of life.

The study, co-authored by Andrew Langford, whilst he was Chief Executive of the British Liver Trust, in association with Marie Curie and the Sheila Sherlock Liver Unit at the Royal Free Hospital, found that when specialist palliative care was considered, patients were only referred, on average, five days before their death.

Clinicians rarely discussed future care preferences and lacked the confidence to initiate discussions, with only 16% of patients having clear discussions with health professionals about place of death. For 8 out of 10 patients (83%), death occurred in hospital.

The researchers explain that the unpredictable trajectory of liver disease presents a specific challenge for clinicians as it can be difficult to identify when deterioration becomes irreversible and patients are dying. This can make it hard to recognise the appropriate time to make a referral for palliative care.

However, the researchers found that some clinicians had a poor understanding of palliative care, which in turn impacted on their ability to explain the benefits to patients.

Vanessa Hebditch, Director of Communications and Policy at the British Liver Trust, said: “Unfortunately more than 35 people die from liver disease every day in the UK; it is essential that we improve the provision of effective end of life care so that as many people die in their place of choice with the best possible palliative and supportive care”.

The research is published in the BMJ journal. A full copy of the paper can be seen here

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