Palliative Care in End-Stage Liver Disease Patients Awaiting Liver Transplantation: Review
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.16/2642 |
Resumo: | Introduction: End-stage liver disease (ESLD) is the advanced phase of most liver diseases. The cure is liver transplantation (LT), only available for a minority of patients. This review summarizes the evidence regarding palliative care (PC) in ESLD patients awaiting LT. Methods: Review of the literature available in Medline, Scopus and Web of Knowledge, with keywords ESLD and PC. Results: Fifteen of the 230 articles reviewed met the inclusion criteria. Ten main themes were addressed: symptom burden; perspectives of life-sustaining treatment and comfort for patients, families and health professionals; goals of care discussions; patient and family needs; quality of life; PC and survival; referral to PC, barriers and opportunities; integration of PC; outpatient care and cost-effectiveness analysis. The referral of patients to PC was only evaluated in a few studies, all of which reported low referral rates. Better knowledge of how PC professionals can support other professionals was considered important, and also better ways to integrate PC were considered essential. Conclusion: ESLD patients awaiting LT have a significant need for PC and, despite the insufficient response, were reported to benefit from this type of care. Future research is essential to determine the means to overcome barriers and better integrate PC for ESLD patients awaiting LT. |
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Palliative Care in End-Stage Liver Disease Patients Awaiting Liver Transplantation: ReviewCuidados Paliativos nos doentes com Doença Hepática avançada que aguardam transplante hepático: revisãoEnd-stage liver diseaseLiver transplantationPalliative careIntroduction: End-stage liver disease (ESLD) is the advanced phase of most liver diseases. The cure is liver transplantation (LT), only available for a minority of patients. This review summarizes the evidence regarding palliative care (PC) in ESLD patients awaiting LT. Methods: Review of the literature available in Medline, Scopus and Web of Knowledge, with keywords ESLD and PC. Results: Fifteen of the 230 articles reviewed met the inclusion criteria. Ten main themes were addressed: symptom burden; perspectives of life-sustaining treatment and comfort for patients, families and health professionals; goals of care discussions; patient and family needs; quality of life; PC and survival; referral to PC, barriers and opportunities; integration of PC; outpatient care and cost-effectiveness analysis. The referral of patients to PC was only evaluated in a few studies, all of which reported low referral rates. Better knowledge of how PC professionals can support other professionals was considered important, and also better ways to integrate PC were considered essential. Conclusion: ESLD patients awaiting LT have a significant need for PC and, despite the insufficient response, were reported to benefit from this type of care. Future research is essential to determine the means to overcome barriers and better integrate PC for ESLD patients awaiting LT.Introdução: A doença hepática avançada (DHA) corresponde à fase mais avançada das doenças hepáticas. O transplante hepático (TH) é o tratamento curativo, disponível apenas para uma minoria de doentes. Esta revisão sumariza a evidência sobre cuidados paliativos (CP) em doentes com DHA que aguardam TH. Métodos: Revisão da literatura existente na Medline, Scopus e Web of Knowledge. Palavras chave pesquisadas CP e DHA. Resultados: Quinze dos 230 artigos encontrados cumpriram critérios de inclusão. Dez temáticas foram abordadas: carga sintomática; discussão de objectivos de cuidados; perspectivas sobre tratamentos de suporte artificial e conforto; necessidades do doente e família; qualidade de vida; CP e impacto no prognóstico; referenciação para CP, barreiras e oportunidades; integração dos CP; cuidados de ambulatório e análises de custo-benefício. Poucos estudos avaliaram a referenciação para CP, todos com baixas taxas. Mais conhecimento e formação dos profissionais que acompanham doentes com DHA parece ser necessário, bem como, melhor articulação entre os diferentes intervenientes. Conclusão: Doentes com DHA que aguardam TH apresentam importantes necessidades de CP. Apesar da insuficiente resposta a este nível, parecem beneficiar deste tipo de cuidados. Estudos futuros que clarifiquem como ultrapassar as barreiras e a melhor integração dos CP nos doentes que aguardam TH são essenciais.Karger AGRepositório Científico do Centro Hospitalar Universitário de Santo AntónioVieira Silva, SaraFreire, ElgaPessegueiro Miranda, Helena2021-12-07T15:06:52Z20202020-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.16/2642engVieira Silva S, Freire E, Pessegueiro Miranda H. Palliative Care in End-Stage Liver Disease Patients Awaiting Liver Transplantation: Review. GE Port J Gastroenterol. 2020;27(6):417-428. doi:10.1159/0005073362387-195410.1159/000507336info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-10-20T11:01:26Zoai:repositorio.chporto.pt:10400.16/2642Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T20:38:50.578846Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Palliative Care in End-Stage Liver Disease Patients Awaiting Liver Transplantation: Review Cuidados Paliativos nos doentes com Doença Hepática avançada que aguardam transplante hepático: revisão |
title |
Palliative Care in End-Stage Liver Disease Patients Awaiting Liver Transplantation: Review |
spellingShingle |
Palliative Care in End-Stage Liver Disease Patients Awaiting Liver Transplantation: Review Vieira Silva, Sara End-stage liver disease Liver transplantation Palliative care |
title_short |
Palliative Care in End-Stage Liver Disease Patients Awaiting Liver Transplantation: Review |
title_full |
Palliative Care in End-Stage Liver Disease Patients Awaiting Liver Transplantation: Review |
title_fullStr |
Palliative Care in End-Stage Liver Disease Patients Awaiting Liver Transplantation: Review |
title_full_unstemmed |
Palliative Care in End-Stage Liver Disease Patients Awaiting Liver Transplantation: Review |
title_sort |
Palliative Care in End-Stage Liver Disease Patients Awaiting Liver Transplantation: Review |
author |
Vieira Silva, Sara |
author_facet |
Vieira Silva, Sara Freire, Elga Pessegueiro Miranda, Helena |
author_role |
author |
author2 |
Freire, Elga Pessegueiro Miranda, Helena |
author2_role |
author author |
dc.contributor.none.fl_str_mv |
Repositório Científico do Centro Hospitalar Universitário de Santo António |
dc.contributor.author.fl_str_mv |
Vieira Silva, Sara Freire, Elga Pessegueiro Miranda, Helena |
dc.subject.por.fl_str_mv |
End-stage liver disease Liver transplantation Palliative care |
topic |
End-stage liver disease Liver transplantation Palliative care |
description |
Introduction: End-stage liver disease (ESLD) is the advanced phase of most liver diseases. The cure is liver transplantation (LT), only available for a minority of patients. This review summarizes the evidence regarding palliative care (PC) in ESLD patients awaiting LT. Methods: Review of the literature available in Medline, Scopus and Web of Knowledge, with keywords ESLD and PC. Results: Fifteen of the 230 articles reviewed met the inclusion criteria. Ten main themes were addressed: symptom burden; perspectives of life-sustaining treatment and comfort for patients, families and health professionals; goals of care discussions; patient and family needs; quality of life; PC and survival; referral to PC, barriers and opportunities; integration of PC; outpatient care and cost-effectiveness analysis. The referral of patients to PC was only evaluated in a few studies, all of which reported low referral rates. Better knowledge of how PC professionals can support other professionals was considered important, and also better ways to integrate PC were considered essential. Conclusion: ESLD patients awaiting LT have a significant need for PC and, despite the insufficient response, were reported to benefit from this type of care. Future research is essential to determine the means to overcome barriers and better integrate PC for ESLD patients awaiting LT. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020 2020-01-01T00:00:00Z 2021-12-07T15:06:52Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.16/2642 |
url |
http://hdl.handle.net/10400.16/2642 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Vieira Silva S, Freire E, Pessegueiro Miranda H. Palliative Care in End-Stage Liver Disease Patients Awaiting Liver Transplantation: Review. GE Port J Gastroenterol. 2020;27(6):417-428. doi:10.1159/000507336 2387-1954 10.1159/000507336 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Karger AG |
publisher.none.fl_str_mv |
Karger AG |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799133648531750912 |