Nurse-Led Clinic for Patients With Decompensated Liver Cirrhosis

Prognosis for patients with decompensated liver cirrhosis is poor and readmissions are frequent. Closer and more structured follow-up by nurses may prevent readmissions and stabilize liver-related complications. We aimed to test the hypothesis that establishing a nurse-led clinic for patients with decompensated liver cirrhosis could prevent hospital admissions.

A quasi-experimental study including complex patients with decompensated cirrhosis and complications. The intervention was a patient-centered and nurse-led clinic. Contacts to the participants were mainly by phone or face-to-face visits in the main outpatient clinic. In addition, the whole cohort of patients with cirrhosis followed in the department was monitored prior to, during, and after the intervention. Data was evaluated using interrupted time series.

A total of 55 patients were enrolled in the clinic between January 2022 and February 2024. Most (55%) became able to self-manage and were discharged from the clinic hereafter. They were characterized by having lower clinical scores and having fewer mental problems. In contrast, 18% were unable to benefit from the clinic. Data on cohort-level showed decreases in outpatient visits (p < 0.05) and admissions (p < 0.005) while the clinic was active.

Establishing a nurse-led clinic for patients with decompensated cirrhosis is feasible and followed by reduced in- and outpatient contacts while the clinic was active.