Palliative care in liver disease: what does good look like

The morbidity and mortality from chronic liver disease is rising rapidly with a high symptom burden in advanced disease. This is an important priority for hepatology. In this issue Hazel Woodland and colleagues, on behalf of the British Association for the Study of Liver Disease (BASL) review palliative care in liver disease - clinical and service related issues. There are important core principles. Palliative care is not confined to end of life care and includes the optimisation of quality of life for patients and families in parallel with active disease management. This means that ‘core’ palliative care should be part of ‘normal care’ offered by the multidisciplinary team with specialist palliative care teams providing input for more complex cases. The article covers basic principles and clinical issues including proposing the establishment of an advanced liver disease multi-disciplinary team to best inform and support care needs, management plans and decisions about limiting care. The article also covers key clinical issues in detail including pro-active management of nutritional impairment, refractory ascites, acute and chronic pain and hepatic encephalopathy and includes helpful discussion of practical issues including psychological, social and financial. Essential reading for clinical teams …