End of Life Special Interest Group 

The End of Life Special Interest Group (SIG) is linked to the Cirrhosis and its Complications CRN topic area. The SIG Lead is Dr Ben Hudson of Royal Devon & Exeter Hospital. The first meeting of the SIG was held in March 2018. If anyone wishes to join the group please contact the BASL secretariat on Samantha@basl.org.uk.  

 

Resources 

SIG DOCUMENTS

Annual report 2017-18 - Download Annual report _2017-18_End of Life SIG.pdf.

Annual report 2018-19 - Download Annual report_2018-19_End of Life SIG.pdf.

Report of 1st meeting - 6 March 2018 - Download summary of outputs from 6th March meeting.pdf.

Report of 2nd meeting - 20 March 2019 - Download Summary of outputs from 20th March meeting.pdf.

All presentations from 2nd meeting - 20 March 2019 -  Download Presentations.pdf.

Position statement on palliative and supportive care in patients with chronic liver disease - Contributors: Mark Wright, Michael Allison, Ben Hudson, Suzanne Ford-Dunn, Fiona Finlay, Graeme Alexander and the BASL End of Life Care Special Interest Group. There is increasing recognition that although great strides have been made in treating liver disease, sadly many patients still succumb to it and need good quality health care in the final stages of their lives, which is sometimes lacking compared to other diseases. In this discussion document, which came out of two meetings of the End of Life SIG, we outline the key issues and suggest a plan of action going forward to improve matters.  Download End of life Care in liver disease for BASL website.pdf.

Prescribing guidelines for patients with end stage liver disease - produced by the End of Life SIG and British Hepatology Pharmacy Group. These guidelines cover the management of common symptoms in patients with advanced liver disease and offer guidance on prescribing of anticipatory medications at the end of life. They should be used for patients with Child Pugh B or C cirrhosis. Evidence in this field is limited, and suggested doses and dosing intervals are based largely on expert opinion. Prescribing practices vary both locally and nationally, and prescribers should refer to local guidelines and use medications they are familiar with whenever possible. As this is an area of limited evidence, the authors would welcome feedback from users to inform future versions of the guideline - contact samantha@basl.org.uk

Download Symptom control in adults with advanced liver disease - BASL Final.pdf

Download Symptom control in adults with advanced liver disease - References.pdf

 

PUBLISHED RESEARCH

This is not a definitive list of publications, but aims to provide an introduction to research into end of life care in liver disease - Download Published research.pdf

 

CURRENT PROJECTS 

The SIG has collated information about examples of current projects, mostly UK based, which are improving care for patients with advanced liver disease.  The following table summarises these projects and provides links to further information on each project. Links to individual project information may also be accessed below. The SIG is keen to receive information on other relevant projects - anyone interested in providing this should contact Samantha@basl.org.uk

Download Summary table.docx

Download Shared Care Liver Project.pdf

Download Early integration of palliative care.pdf

Download Patient Information Leaflet V2 (Bristol).pdf

Download Validation of prognostic screening tools.pdf

Download Development of a QPL.pdf

Download Thinking Ahead Clinic.pdf

Download Thinking ahead - ACP Example Document.pdf

Download Thinking Ahead - ACP Example GP letter.pdf

Download REDUCe published manuscript.pdf

Download Worthing collaboration - ALD MDT and community based ALD Nurse.pdf

https://www.pcori.org/research-results/2017/comparing-two-ways-offer-palliative-care-improve-quality-life-patients-end 

 

USEFUL WEBSITES

Palliative care support for those who are homeless:

https://www.homelesspalliativecare.com/ 

https://www.pathway.org.uk/services/end-life-care-homelessness/ 

British Liver Trust ‘Thinking Ahead’ palliative and supportive care leaflet:

https://www.britishlivertrust.org.uk/liver-information/thinking-ahead-planning-for-your-future-when-you-have-advanced-liver-disease/ 

E learning on end of life care, a Health Education England programme working in partnership with the NHS and professional bodies to support patient care:

https://www.e-lfh.org.uk/programmes/end-of-life-care/  

 

News

Prescribing guidelines for patients with end stage liver disease have been produced by the End of Life SIG and British Hepatology Pharmacy Group. These are available in the resources section of this webpage. 

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