Evidence map›Paper›PMID 42304310›Full record

ArticleBMC palliative care2026

LiverCare - a palliative care intervention for patients with liver cirrhosis: study protocol for a multi-center, pragmatic, non-randomised clinical trial.

Malene Barfod O'Connell, Birgitte Gade Jacobsen, Ane Søgaard Teisner, Palle Bager, Marie Louise Hamberg, Janni Mendahl, Kristoffer Marsaa, Mai-Britt Guldin, Nina Kimer, Mette Munk Lauridsen and 1 more

Registry-linked trialAbstract readClinical Trial Protocol
In one paragraph

Article in BMC palliative care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05431946 (Palliative Care for Patients With Liver Cirrhosis - a Multicentre Intervention Study), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05431946 enrolling by invitationnot on this map

Palliative Care for Patients With Liver Cirrhosis - a Multicentre Intervention Study

TypeobservationalSponsorEsbjerg Hospital - University Hospital of Southern DenmarkRan2023 to 2028Enrolled200ConditionsEnd of Life Care, Liver Cirrhosis, Nurse-Patient Relations, Quality of LifeArmsAdvance Care Planning and the consequent actions
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Malene Barfod O'ConnellGastro Unit, Copenhagen University Hospital, Amager Hvidovre, Denmark. malene.barfod.oconnell@regionh.dk.
Birgitte Gade JacobsenDepartment of Gastroenterology, University Hospital of Southern Denmark, Esbjerg, Denmark.
Ane Søgaard TeisnerDepartment of Gastroenterology and Hepatology, Copenhagen University Hospital, Herlev Gentofte, Denmark.
Palle BagerDepartment of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
Marie Louise HambergDepartment of Gastroenterology and Hepatology, Copenhagen University Hospital, Herlev Gentofte, Denmark.
Janni MendahlDepartment of Palliative Care, Copenhagen University Hospital, Herlev Gentofte, Denmark.
Kristoffer MarsaaSteno Diabetes Center Copenhagen, Denmark and Nursing Home Dagmarsminde, Herlev, Graested, Denmark.
Mai-Britt GuldinCenter for Grief and Existential Values, Research Unit for General Practice, Aarhus University, Aarhus, Denmark.
Nina KimerGastro Unit, Copenhagen University Hospital, Amager Hvidovre, Denmark.
Mette Munk LauridsenDepartment of Gastroenterology, University Hospital of Southern Denmark, Esbjerg, Denmark.
Lea LadegaardDepartment of Gastroenterology, University Hospital of Southern Denmark, Esbjerg, Denmark.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn the transition from compensated to decompensated cirrhosis, median survival decreases from 12 to two years, and patients face some of the highest rates of unplanned hospital admissions. Despite existing recommendations, palliative care is not routinely offered to this population. The aim of this study is to evaluate the effectiveness and implementation of an interdisciplinary palliative care intervention for patients with cirrhosis and their informal caregivers.

methodsThe LiverCare study is a multi-center, mixed-method, pragmatic, non-randomised clinical study with a hybrid type 1 effectiveness-implementation design. The study is conducted in hepatology departments across four hospitals in three of Denmark's five regions. It is guided by the British Medical Research Council and Reach, Effectiveness, Adaption, Implementation, Monitor frameworks and includes both a feasibility study and a mixed-method process evaluation. The LiverCare intervention is grounded in a palliative approach, emphasising open, exploratory palliative care conversations. The intervention is integrated into routine outpatient care and the palliative care conversations are delivered by hepatologists and liver nurses who attended a specially designed course within palliative care. Eligible participants are adults with decompensated liver cirrhosis of any etiology who meet at least one general and one disease-specific palliative care indicator, assessed using the Supportive and Palliative Care Indicators Tool. Informal caregivers are invited to participate in the intervention. Palliative care conversations are initiated following a formal invitation and continue after four to ten weeks and then every six months up to 36 months or until study withdrawal or death. The primary outcome is healthcare utilization, defined as the number and length of hospital admissions, compared to a historic cohort. Secondary outcomes include outpatient contacts, symptom burden, quality of life, and caregiver burden. The study also includes cost-effectiveness and cost-utility analysis. DISCUSSION: Insights gained from the study will inform future implementation strategies and contribute to the advancement of palliative care practices in hepatology. The results will further support education, training, and competence development for healthcare professionals caring for patients with advanced liver disease.

trial registrationThe study is registered on clinicaltrials.gov (NCT05431946), approved by The Danish Data Protection Agency and reported to the Committee on Health Research Ethics (20222000-31).

Indexed as

Liver CirrhosisPalliative CareDenmarkFemaleHumansMulticenter Studies as TopicPragmatic Clinical Trials as TopicAdvance care planningCirrhosisImplementationInterventionsLiver diseasePalliative care.

Identifiers

PMID42304310
PMCPMC13504752

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.