Exploring Patient and Provider Narratives: A Qualitative Study Identifying Barriers in Liver Transplantation Referral

Area of Science:

• Hepatology
• Transplantation Medicine
• Public Health

Background:

• Chronic liver disease (CLD) poses a significant public health challenge in the US.
• Liver transplantation (LT) is the sole life-saving treatment for decompensated cirrhosis.
• Referral is the critical first step in the LT process, yet barriers disproportionately affect underserved populations.

Purpose of the Study:

• To identify systemic, interpersonal, and informational barriers to liver transplantation referrals.
• To expand existing research on factors influencing LT referrals.

Main Methods:

• Conducted semi-structured interviews with 15 patients and 11 healthcare providers across 10 gastroenterology practices in Indiana.
• Analyzed transcribed interview data using a six-phase thematic analysis framework.

Main Results:

• Identified key barriers including long travel distances, lengthy appointment wait times, and communication challenges within the healthcare system.
• Highlighted limitations in provider referral tools and insufficient patient support resources.

Conclusions:

• Addressing identified barriers can potentially increase liver transplantation referrals.
• Interventions focused on overcoming these obstacles may improve access to LT for medically underserved and marginalized communities.