Integrated Model for Patient-Centered Advanced Liver Disease Care.

Integrated Model for Patient-Centered Advanced Liver Disease Care.
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DOI:
10.1016/j.cgh.2019.07.043
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发表时间:
2020-05
影响因子:
12.6
通讯作者:
Kanwal, Fasiha
Kanwal, Fasiha
中科院分区:
医学1区
文献类型:
--
作者:
Naik, Aanand D.;Arney, Jennifer;Clark, Jack A.;Martin, Lindsey A.;Paragraph, Anne M. Walling;Stevenson, Autumn;Smith, Donna;Asch, Steven M.;Kanwal, Fasiha

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晚期肝病(AdvLD)是一种高风险的常见疾病,具有进行性、高发病率且往往致命的病程。尽管有有效的治疗方法,但在晚期肝病获得和使用基于证据的支持性和姑息治疗方面存在重大不足。尽管以患者为中心、将早期支持性和姑息治疗与治愈性治疗相结合的慢性病模式有希望,但存在一些知识缺口阻碍了晚期肝病综合模式的发展。我们回顾了这些证据缺口。我们还描述了一种以患者为中心的方法的概念框架,该框架阐述了改善综合治疗所需的关键要素。晚期肝病的综合模式将使临床医生、患者和护理人员能够协同工作,以确定最符合患者优先事项的治疗方法和其他医疗保健措施。
Advanced liver disease (AdvLD) is a high-risk common condition with a progressive, highly morbid, and often fatal course. Despite effective treatments, there are substantial shortfalls in access to and use of evidence-based supportive and palliative care for AdvLD. Although patient-centered, chronic illness models that integrate early supportive and palliative care with curative treatments hold promise, there are several knowledge gaps that hinder development of an integrated model for AdvLD. We review these evidence gaps. We also describe a conceptual framework for a patient-centered approach that explicates key elements needed to improve integrated care. An integrated model of AdvLD would allow clinicians, patients, and caregivers to work collaboratively to identify treatments and other healthcare that best align with patients’ priorities.
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