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Tobias Malte Larsen¹, Malene Barfod O'Connell², Ane Teisner³

¹Abdominalcenter K, Københavns Universitetshospital - Bispebjerg og Frederiksberg Hospital.

Ugeskrift for Laeger

|November 3, 2023

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Advance care planning (ACP) is recommended for all patients with life-threatening illnesses. This review focuses on identifying and supporting palliative care goals for patients with decompensated liver cirrhosis.

Area of Science:

Palliative Care
Hepatology
Medical Ethics

Background:

The Danish Health Authority recommends palliative care for all patients with life-threatening diseases, respecting individual goals of care.
Limited research exists on advance care planning (ACP) for patients with decompensated liver cirrhosis.
Decompensated liver cirrhosis is a life-threatening condition requiring proactive palliative care discussions.

Approach:

This review synthesizes current evidence on identifying patients with decompensated liver cirrhosis who need palliative care.
It outlines methods for analyzing and understanding patient goals of care within this population.
A practical strategy for conducting ACP conversations and integrating them into clinical practice is presented.

Key Points:

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Identifying patients with decompensated liver cirrhosis who would benefit from palliative care is crucial.

Analyzing and respecting individual goals of care is a cornerstone of effective palliative care.

A structured approach to ACP conversations can improve patient outcomes and align care with patient wishes.

Conclusions:

Implementing advance care planning for patients with decompensated liver cirrhosis is essential.
A systematic strategy can facilitate meaningful ACP conversations in daily clinical work.
This approach ensures patient-centered care and respects individual autonomy in end-of-life decision-making.