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O-15 A shared care pathway for people with advanced liver disease (ALD); innovation or idealistic?
  1. Virginia Campbell and
  2. Sharon Quinn
  1. St Luke’s Hospice, Basildon, UK


Background People with ALD have complex end-of-life needs. Palliative care provision or clear national guidance is limited. An innovative, unique joint hepatology/specialist palliative care project exploring a parallel planning approach has been established between the hospice and secondary care, which will lead the learning for hospices around ALD and non-malignant conditions.

Aims To explore the impact of this shared care approach on patient and carer outcomes and experience.

Methods Patients were recruited by the hospice Specialist Nurse Practitioner (SNP) from hepatology hospital clinics. The SNP offered holistic needs assessment, opportunities to discuss advance care planning and access to supportive care at the hospice whilst patients remained under hepatology management. Patients were reassessed four to eight weekly using OACC measures and the Short Form Liver Disease Quality of Life Assessment. Carers were assessed using CSNAT. In addition to analysis of patient data, hospital admission, A and E and GP visit avoidance was evaluated to assess health economics and quality of life.

Results A total of 38 patients were registered. At baseline our sample (n=36) had a mean I-POS of 27.4 (range 4–64) and a mean AKPS score of 68.3(range 50.90). At the four month assessment, the sample (n=23) had a mean I-POS of 19.7 (range 1–42) and a mean AKPS score of 77.0 (range 50–90). Preliminary analysis suggests that patients receiving early hospice intervention have reduced symptom burden and improved performance status. This was further supported by focus group feedback which highlighted continuity of care and open communication as contributing to improved well-being.

Conclusions Final data will be presented at the conference demonstrating key learning points from this collaborative and innovative approach which will lead and inform future service provision across hospices. Early and timely introduction to hospice services is beneficial to this marginalised group and this model is replicable for people with other non-malignant conditions.

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