Palliative care & management of symptoms in advanced liver disease: an expert review.

IF 3.8 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-04-01 Epub Date: 2025-04-10 DOI:10.1080/17474124.2025.2491529

Jessica L Allen, Richard K Sterling

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引用次数: 0

Abstract

Introduction: Chronic liver disease (CLD) is a leading cause of death worldwide. End-stage liver disease (ESLD) causes a rapid and progressive decline in health and quality of life (QOL) and creates significant suffering and burdens for patients, families, and health systems alike. These patients have significant physical, psychological, and complex social needs that benefit from the support of an interdisciplinary palliative care (PC) team.

Areas covered: This review of the English literature analyzes general palliative care principles for the CLD and ESLD populations including factors affecting QOL and review of symptom management per AASLD and AGA Guidelines. We have also reviewed the impacts of palliative support on QOL, caregiver burden, and healthcare-related outcomes.

Expert opinion: ESLD causes significant suffering and burdens for patients, families, and healthcare systems. PC is an essential component of ESLD care; it improves QOL, reduces caregiver burdens, and shows benefits of reduced healthcare costs and aggressive care at end of life. Provider and community misunderstanding or inexperience of PC is often a barrier to PC involvement. There is a clear lack of standardization in medical training and lack of clear guidelines on when to involve PC in the ESLD population that must be addressed.

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晚期肝病的姑息治疗和症状管理：专家综述。

慢性肝病（CLD）是世界范围内死亡的主要原因。终末期肝病（ESLD）导致健康和生活质量（QOL）的迅速和渐进下降，并给患者、家庭和卫生系统带来巨大的痛苦和负担。这些患者有显著的生理、心理和复杂的社会需求，受益于跨学科姑息治疗（PC）团队的支持。涵盖领域：这篇英文文献综述分析了CLD和ESLD人群的一般姑息治疗原则，包括影响生活质量的因素以及根据AASLD和AGA指南对症状管理的回顾。我们还回顾了姑息支持对生活质量、护理人员负担和医疗保健相关结果的影响。专家意见：ESLD给患者、家庭和卫生保健系统带来巨大痛苦和负担。PC是ESLD护理的重要组成部分，可以改善生活质量，减轻护理人员的负担，并显示出降低医疗保健成本和临终时积极护理的好处。供应商和社区对PC的误解或缺乏经验往往是PC参与的障碍。医疗培训显然缺乏标准化，也缺乏关于何时将个人护理纳入ESLD人群的明确指导方针，这些问题必须加以解决。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Gastroenterology & Hepatology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

6.80

自引率

2.60%

发文量

审稿时长

6-12 weeks

期刊介绍： The enormous health and economic burden of gastrointestinal disease worldwide warrants a sharp focus on the etiology, epidemiology, prevention, diagnosis, treatment and development of new therapies. By the end of the last century we had seen enormous advances, both in technologies to visualize disease and in curative therapies in areas such as gastric ulcer, with the advent first of the H2-antagonists and then the proton pump inhibitors - clear examples of how advances in medicine can massively benefit the patient. Nevertheless, specialists face ongoing challenges from a wide array of diseases of diverse etiology.