The Patient’s Perspective in Cirrhosis: Unmet Supportive Care Needs Differ by Disease Severity, Etiology, and Age
Patients with cirrhosis have significant physical, psychological, and practical needs. We documented patients’ perceived need for support with these issues and the differences with increasing liver disease severity, etiology, and age. Using the supportive needs assessment tool for cirrhosis (SNAC),...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Health/LWW
2021-05-01
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| Series: | Hepatology Communications |
| Online Access: | https://doi.org/10.1002/hep4.1681 |
| _version_ | 1797935343152922624 |
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| author | Patricia C. Valery Christina M. Bernardes Benjamin Mckillen Samath Amarasena Katherine A. Stuart Gunter Hartel Paul J. Clark Richard Skoien Tony Rahman Leigh Horsfall Kelly Hayward Rohit Gupta Andrew Lee Leshni Pillay Elizabeth E. Powell |
| author_facet | Patricia C. Valery Christina M. Bernardes Benjamin Mckillen Samath Amarasena Katherine A. Stuart Gunter Hartel Paul J. Clark Richard Skoien Tony Rahman Leigh Horsfall Kelly Hayward Rohit Gupta Andrew Lee Leshni Pillay Elizabeth E. Powell |
| author_sort | Patricia C. Valery |
| collection | DOAJ |
| description | Patients with cirrhosis have significant physical, psychological, and practical needs. We documented patients’ perceived need for support with these issues and the differences with increasing liver disease severity, etiology, and age. Using the supportive needs assessment tool for cirrhosis (SNAC), we examined the rate of moderate‐to‐high unmet needs (Poisson regression; incidence rate ratio [IRR]) and the correlation between needs and sociodemographic/clinical characteristics (multivariable linear regression) in 458 Australians adults with cirrhosis. Primary liver disease etiology was alcohol in 37.6% of patients, chronic viral hepatitis C in 25.5%, and nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH) in 23.8%. A total of 64.6% of patients had Child‐Pugh class A cirrhosis. Most patients (81.2%) had at least one moderate‐to‐high unmet need item; more than 25% reported a moderate‐to‐high need for help with “lack of energy,” “sleep poorly,” “feel unwell,” “worry about … illness getting worse (liver cancer),” “have anxiety/stress,” and “difficulty with daily tasks.” Adjusting for key sociodemographic/clinical factors, patients with Child‐Pugh C had a greater rate of “practical and physical needs” (vs. Child‐Pugh A; IRR = 2.94, 95% confidence interval [CI] 2.57‐3.37), patients with NAFLD/NASH had a greater rate of needs with “lifestyle changes” (vs. alcohol; IRR = 1.81, 95% CI 1.18‐2.77) and “practical and physical needs” (IRR = 1.43, 95% CI 1.23‐1.65), and patients aged ≥65 years had fewer needs overall (vs. 18‐64 years; IRR = 0.70, 95% CI 0.64‐0.76). Higher overall SNAC scores were associated with Child‐Pugh B and C (both P < 0.001), NAFLD/NASH (P = 0.028), patients with “no partner, do not live alone” (P = 0.004), unemployment (P = 0.039), ascites (P = 0.022), and dyslipidemia (P = 0.024) compared with their counterparts. Conclusion: Very high levels of needs were reported by patients with cirrhosis. This information is important to tailor patient‐centered care and facilitate timely interventions or referral to support services. |
| first_indexed | 2024-04-10T18:12:57Z |
| format | Article |
| id | doaj.art-bdc02b8c66e645dab292e90a0b73d35a |
| institution | Directory Open Access Journal |
| issn | 2471-254X |
| language | English |
| last_indexed | 2024-04-10T18:12:57Z |
| publishDate | 2021-05-01 |
| publisher | Wolters Kluwer Health/LWW |
| record_format | Article |
| series | Hepatology Communications |
| spelling | doaj.art-bdc02b8c66e645dab292e90a0b73d35a2023-02-02T10:25:11ZengWolters Kluwer Health/LWWHepatology Communications2471-254X2021-05-015589190510.1002/hep4.1681The Patient’s Perspective in Cirrhosis: Unmet Supportive Care Needs Differ by Disease Severity, Etiology, and AgePatricia C. Valery0Christina M. Bernardes1Benjamin Mckillen2Samath Amarasena3Katherine A. Stuart4Gunter Hartel5Paul J. Clark6Richard Skoien7Tony Rahman8Leigh Horsfall9Kelly Hayward10Rohit Gupta11Andrew Lee12Leshni Pillay13Elizabeth E. Powell14QIMR Berghofer Medical Research Institute Herston QLD AustraliaQIMR Berghofer Medical Research Institute Herston QLD AustraliaDepartment of Gastroenterology and Hepatology Princess Alexandra Hospital Brisbane QLD AustraliaDepartment of Gastroenterology and Hepatology Royal Brisbane and Women’s Hospital Brisbane QLD AustraliaDepartment of Gastroenterology and Hepatology Princess Alexandra Hospital Brisbane QLD AustraliaQIMR Berghofer Medical Research Institute Herston QLD AustraliaDepartment of Gastroenterology and Hepatology Princess Alexandra Hospital Brisbane QLD AustraliaDepartment of Gastroenterology and Hepatology Royal Brisbane and Women’s Hospital Brisbane QLD AustraliaGastroenterology & Hepatology Department Prince Charles Hospital Chermside QLD AustraliaDepartment of Gastroenterology and Hepatology Princess Alexandra Hospital Brisbane QLD AustraliaDepartment of Gastroenterology and Hepatology Princess Alexandra Hospital Brisbane QLD AustraliaGastroenterology & Hepatology Department Prince Charles Hospital Chermside QLD AustraliaDepartment of Gastroenterology and Hepatology Mater Hospitals Brisbane QLD AustraliaDepartment of Gastroenterology and Hepatology Logan Hospital Meadowbrook QLD AustraliaDepartment of Gastroenterology and Hepatology Princess Alexandra Hospital Brisbane QLD AustraliaPatients with cirrhosis have significant physical, psychological, and practical needs. We documented patients’ perceived need for support with these issues and the differences with increasing liver disease severity, etiology, and age. Using the supportive needs assessment tool for cirrhosis (SNAC), we examined the rate of moderate‐to‐high unmet needs (Poisson regression; incidence rate ratio [IRR]) and the correlation between needs and sociodemographic/clinical characteristics (multivariable linear regression) in 458 Australians adults with cirrhosis. Primary liver disease etiology was alcohol in 37.6% of patients, chronic viral hepatitis C in 25.5%, and nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH) in 23.8%. A total of 64.6% of patients had Child‐Pugh class A cirrhosis. Most patients (81.2%) had at least one moderate‐to‐high unmet need item; more than 25% reported a moderate‐to‐high need for help with “lack of energy,” “sleep poorly,” “feel unwell,” “worry about … illness getting worse (liver cancer),” “have anxiety/stress,” and “difficulty with daily tasks.” Adjusting for key sociodemographic/clinical factors, patients with Child‐Pugh C had a greater rate of “practical and physical needs” (vs. Child‐Pugh A; IRR = 2.94, 95% confidence interval [CI] 2.57‐3.37), patients with NAFLD/NASH had a greater rate of needs with “lifestyle changes” (vs. alcohol; IRR = 1.81, 95% CI 1.18‐2.77) and “practical and physical needs” (IRR = 1.43, 95% CI 1.23‐1.65), and patients aged ≥65 years had fewer needs overall (vs. 18‐64 years; IRR = 0.70, 95% CI 0.64‐0.76). Higher overall SNAC scores were associated with Child‐Pugh B and C (both P < 0.001), NAFLD/NASH (P = 0.028), patients with “no partner, do not live alone” (P = 0.004), unemployment (P = 0.039), ascites (P = 0.022), and dyslipidemia (P = 0.024) compared with their counterparts. Conclusion: Very high levels of needs were reported by patients with cirrhosis. This information is important to tailor patient‐centered care and facilitate timely interventions or referral to support services.https://doi.org/10.1002/hep4.1681 |
| spellingShingle | Patricia C. Valery Christina M. Bernardes Benjamin Mckillen Samath Amarasena Katherine A. Stuart Gunter Hartel Paul J. Clark Richard Skoien Tony Rahman Leigh Horsfall Kelly Hayward Rohit Gupta Andrew Lee Leshni Pillay Elizabeth E. Powell The Patient’s Perspective in Cirrhosis: Unmet Supportive Care Needs Differ by Disease Severity, Etiology, and Age Hepatology Communications |
| title | The Patient’s Perspective in Cirrhosis: Unmet Supportive Care Needs Differ by Disease Severity, Etiology, and Age |
| title_full | The Patient’s Perspective in Cirrhosis: Unmet Supportive Care Needs Differ by Disease Severity, Etiology, and Age |
| title_fullStr | The Patient’s Perspective in Cirrhosis: Unmet Supportive Care Needs Differ by Disease Severity, Etiology, and Age |
| title_full_unstemmed | The Patient’s Perspective in Cirrhosis: Unmet Supportive Care Needs Differ by Disease Severity, Etiology, and Age |
| title_short | The Patient’s Perspective in Cirrhosis: Unmet Supportive Care Needs Differ by Disease Severity, Etiology, and Age |
| title_sort | patient s perspective in cirrhosis unmet supportive care needs differ by disease severity etiology and age |
| url | https://doi.org/10.1002/hep4.1681 |
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