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Advance Care Planning and Goals of Care Discussions in Advanced Liver Disease

  • Palliative Care (A Patel, Section Editor)
  • Published:
Current Hepatology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Advance care planning (ACP) has been shown to improve multiple outcomes in patients with serious illnesses; however, patients with advanced liver disease, or cirrhosis, rarely receive timely ACP. The purpose of this review is to evaluate the current state of ACP for patients with advanced liver disease and to provide practical guidance for integrating early ACP into routine outpatient hepatology care.

Recent Findings

Due to multiple patient-, physician-, and systems-level barriers, patients with advanced liver disease have low rates of timely ACP engagement. Early identification and preparation of a surrogate decision-maker, enhancing clinician ACP communication skills, use of patient-centered educational tools, optimizing outpatient processes for ACP documentation, and early referral to specialty palliative care may help to improve current deficits in ACP for this population.

Summary

Provision of early ACP to patients with advanced liver disease may better ensure that patients receive medical care that is consistent with their goals and values.

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Abbreviations

ACP:

Advance care planning

CPR:

Cardiopulmonary resuscitation

GOC:

Goals of care

ICU:

Intensive care unit

MELD:

Model for End-Stage Liver Disease

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Ufere, N.N. Advance Care Planning and Goals of Care Discussions in Advanced Liver Disease. Curr Hepatology Rep 20, 77–84 (2021). https://doi.org/10.1007/s11901-021-00565-x

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