ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2019
Barriers to Use of Palliative Care and Advance Care Planning Discussions for Patients With End-Stage Liver Disease.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 2 of them syntheses that pooled it.
What it found
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Who cites it
45 citing papers in PubMed, 2 syntheses or guidelines pooled it, 108 citations in OpenAlex.
- EASL position paper on palliative care in advanced chronic liver disease.JHEP reports : innovation in hepatology · 2026Guideline
- How does ethnicity affect presence of advance care planning in care records for individuals with advanced disease? A mixed-methods systematic review.BMC palliative care · 2023Pooled it
- Palliative Care Always: Hepatology-Virtual Primary Palliative Care Training for Hepatologists.Hepatology communications · 2022Trial
- Palliative Care Co-management at a Liver Transplant Center: A Mixed Methods Study.Digestive diseases and sciences · 2026Article
- Comparison of Factors Associated With 30-Day and 90-Day Readmission Among a Global Cohort of Patients Hospitalised With Cirrhosis.Liver international : official journal of the International Association for the Study of the Liver · 2026Article
- Comparison of Palliative Care Access Between Patients With Liver Cirrhosis and Hepatocellular Carcinoma: Nationwide Population-Based Study.Journal of Korean medical science · 2026Article
- Advancing Advance Directive Completion Rates in Patients with Decompensated Cirrhosis.Digestive diseases and sciences · 2026Article
- Evidence-Based Frameworks Increase Engagement in Serious Illness Communication Conversations for Patients With Cirrhosis.The American journal of hospice & palliative care · 2026Article
- The LiverCare intervention: implementing structured palliative care in hepatology - a multicenter mixed-methods feasibility study in patients with cirrhosis.BMC palliative care · 2026Article
- Barriers and Strategies to Effective Serious Illness Communication for Patients with End-Stage Liver Disease in the Intensive Care Setting.Journal of intensive care medicine · 2026Review
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- Article
- Role self-ascription of professionals conducting advance care planning conversations: A thematic analysis.Palliative medicine · 2025Article
- Palliative care in terminally ill advanced chronic liver disease patients.Wiener klinische Wochenschrift · 2025Review
- Symptom burden in end-stage liver disease: a prospective cohort study of the symptoms experienced by patients and the role of palliative care.Therapeutic advances in gastroenterology · 2025Article
- Palliative care for end-stage liver disease and acute on chronic liver failure: A systematic review.World journal of methodology · 2024Article
- Healthcare Resource Utilization and Goals of Care Discussions in Patients with Cirrhosis and Acute Kidney Injury.Digestive diseases and sciences · 2024Article
- Rates, patterns, and predictors of specialty palliative care consultation among patients with acute-on-chronic liver failure.JHEP reports : innovation in hepatology · 2024Article
- Serious Illness Communication in Cirrhosis Care: Tools to Improve Illness Understanding, Prognostic Understanding, and Care Planning.Gastro hep advances · 2024Article
- Association Between Quality of Life Defined by EuroQol Group 5 Dimension and Composite Inferior Outcome Among Inpatients with Cirrhosis.Clinical interventions in aging · 2024Article
Corrections and comments
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Authors and funding
16 authors at 3 institutions in 1 country.
Funding
Abstract
BACKGROUND &
aimsDespite evidence for the benefits of palliative care (PC) referrals and early advance care planning (ACP) discussions for patients with chronic diseases, patients with end-stage liver disease (ESLD) often do not receive such care. We sought to examine physicians' perceptions of the barriers to PC and timely ACP discussions for patients with ESLD.
methodsWe conducted a cross-sectional survey of hepatologists and gastroenterologists who provide care to adult patients with ESLD, recruited from the American Association for the Study of Liver Diseases 2018 membership registry. Using a questionnaire adapted from prior studies, we assessed physicians' perceptions of barriers to PC use and timely ACP discussions; 396 of 1236 eligible physicians (32%) completed the questionnaire.
resultsThe most commonly cited barriers to PC use were cultural factors that affect perception of PC (by 95% of respondents), unrealistic expectations from patients about their prognosis (by 93% of respondents), and competing demands for clinicians' time (by 91% of respondents). Most respondents (81%) thought that ACP discussions with patients who have ESLD typically occur too late in the course of illness. The most commonly cited barriers to timely ACP discussions were insufficient communication between clinicians and families about goals of care (by 84% of respondents) and insufficient cultural competency training about end-of-life care (81%).
conclusionThere are substantial barriers to use of PC and timely discussions about ACP-most hepatologists and gastroenterologists believe that ACP occurs too late for patients with ESLD. Strategies are needed to overcome barriers and increase delivery of high-quality palliative and end-of-life care to patients with ESLD.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.