Identifying palliative care needs in a Portuguese liver unit

摘要

Abstract Background & Aims Chronic liver disease is a major worldwide cause of morbidity and mortality. Palliative care policies are not clearly established in chronic liver disease. The NECPAL CCOMS ‐ ICO ? ( NEC esidades PAL iativas/Palliative Needs) is a tool to identify palliative care needs, including a section for liver disease. Aim: The aim of this study was to identify palliative care needs in liver patients hospitalised in a tertiary referral Liver Unit. Methods Single‐centre prospective observational study. One hundred and twenty patients with cirrhosis were included and NECPAL questionnaire was applied to all patients in a 7‐month period. Results 84.2% of patients were considered as requiring palliative intervention; however, clinicians identified those needs only in 65.8% of the cases and caregivers in 6.7% of the cases; less than 8% of the patients were referred for palliative care consultation. An excessive use of healthcare resources (positive answer to question 3) was strongly associated with a positive need for palliative care (positive NECPAL ): OR 7.305, CI 95% 2.54‐20.995, P ??.001). An excessive use of healthcare facilities has a sensitivity of 84.2% and a specificity of 42.1% for prediction of a positive NECPAL result ( AUC 0.710, 95% CI 0.570‐0.850, P ?=?.004). Conclusions The NECPAL CCOMS ‐ ICO ? represents a feasible and easy‐to‐use tool to identify palliative care needs in patients with chronic liver disease.