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Hepatic encephalophathy: management and diagnostic therapeutic assistance path of Ligurian Local Health Company 3
Gianni Testino1, Luigi C Bottaro2, Enzo Andorno3
1Addiction and Hepatology Unit/Alcohological Regional Centre and Study Centre "Self Help, Community Program and Caregiver Training" ASL3, Genoa, Italy - gianni.testino@asl3.liguria.it.
Insights
Hepatic encephalopathy (HE), a condition affecting 20-80% of cirrhotic patients, necessitates dedicated care pathways. This approach improves patient and caregiver quality of life while reducing healthcare costs.
Area of Science:
- Hepatology
- Neurology
- Public Health
Background:
- Hepatic encephalopathy (HE) is a prevalent neuropsychiatric syndrome in cirrhotic patients (20-80%).
- HE contributes to hospitalizations, caregiver burden, and increased societal costs.
- There is a critical need for structured care pathways to manage HE patients and support their caregivers.
Purpose of the Study:
- To develop a diagnostic and therapeutic assistance path (DTAP) for managing hepatic encephalopathy.
- To integrate multidisciplinary care with community medicine and involve caregivers in the management process.
- To enhance patient and caregiver quality of life and reduce healthcare expenditures.
Main Methods:
- Comprehensive literature review of scientific articles published before June 30, 2022 (PubMed, Web of Science, Scopus, Google Scholar).
- Consultation of guidelines and position papers from key international and national liver and alcohol societies (e.g., ISHEN, AISF, EASL, AASLD, SIA).
- Development of a DTAP based on the latest scientific recommendations and multidisciplinary input.
Main Results:
- The DTAP emphasizes the importance of integrated, multidisciplinary care.
- Close collaboration with caregivers is highlighted as crucial for management.
- The proposed pathway aims to improve therapeutic adherence and reduce hospital readmissions.
Conclusions:
- Dedicated care pathways are essential for optimizing hepatic encephalopathy management.
- Integrating territorial medicine and caregiver support improves patient outcomes and reduces costs.
- The DTAP provides a framework for better patient care, caregiver support, and healthcare resource utilization.
Abstract:
Hepatic encephalophathy (HE) is a neuropsychiatric syndrome with a prevalence in the cirrhotic population ranging from 20 to 80%. HE is a cause of inappropriate hospitalization, caregiver burdening and increased social costs. There is need to create dedicated care pathways to better manage patients and support family caregivers. The data used for the preparation of this diagnostic therapeutic assistance path (DTAP) are based on a detailed analysis of the scientific literature published before June 30, 2022 (PubMed, Web of Science, Scopus, Google Scholar). Furthermore, in the process of developing this work, we consulted in particular the guidelines/ position papers of International Society for Hepatic Encephalopathy and Nitrogen Metabolism (ISHEN), Italian Association for the Study of the Liver (AISF), European Association for the Study of the Liver (EASL), American Association for the Study of Liver Diseases (AASLD), Italian Society on Alcohol (Società Italiana di Alcologia [SIA]) and other relevant papers. DTAP was created based on the most recent recommendations of the international scientific literature. The present DTAP highlight the need for a multidisciplinary activity integrated with territorial medicine in close connection with caregivers. This guarantees improved therapeutic adherence, hospital readmission reduction, improved quality of life for patients and caregivers and a significant reduction in costs.
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