Benefit of Early Palliative Care Intervention in End-Stage Liver Disease Patients Awaiting Liver Transplantation

Alexandra J. Baumann, David S. Wheeler, Marva James, Roberta Turner, Arthur Siegel, Victor J. Navarro*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

59 Scopus citations


Background Patients with end-stage liver disease have a predictable and progressive decline in their quality of life because of physical symptoms and psychological distress. Early palliative care intervention (EPCI) correlates with better symptom control and mood. We aimed to improve symptomatology and mood in liver transplant candidates by implementing a longitudinal multidisciplinary EPCI. Measures Depression level and symptom burden were assessed with Center for Epidemiological Studies Depression Scale and a modified liver-specific Edmonton Symptom Assessment System scale. Intervention All patients referred for liver transplant evaluation between July 2013 and May 2014 were scheduled for EPCI. Outcomes After EPCI, 50% of moderate-to-severe symptoms improved (P < 0.05), and 43% of patients showed improvement in clinically significant depressive symptoms (P = 0.003). Notably, patients with more symptoms showed a greater improvement in Center for Epidemiological Studies Depression Scale scores (P = 0.001). Conclusions/Lessons Learned Implementation of EPCI improved symptom burden and mood in end-stage liver disease patients awaiting transplant.

Original languageEnglish (US)
Pages (from-to)882-886.e2
JournalJournal of Pain and Symptom Management
Issue number6
StatePublished - Dec 1 2015
Externally publishedYes


  • CES-D
  • ESAS
  • End-stage liver disease
  • cirrhosis
  • early palliative care intervention
  • liver transplant

ASJC Scopus subject areas

  • Nursing(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine


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