<b>P-146</b>  Shared care liver project

Campbell, Virginia; Quinn, Sharon

doi:10.1136/bmjspcare-2016-001245.169

Cited by 2 publications

(2 citation statements)

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“…As complex EoLC needs are often present, management remains mainly within secondary care with over 70% dying in hospital . In England, despite pockets of excellence, little specialist palliative care is provided in hospices or the community, despite services being available…”

Section: Discussionmentioning

confidence: 99%

Permanent indwelling peritoneal catheters for palliation of refractory ascites in end‐stage liver disease: A systematic review

Macken

Hashim

Mason

et al. 2019

Liver International

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Background & Aims The incidence and mortality from end‐stage liver disease is increasing, with a minority eligible for liver transplantation. Ascites is the commonest complication of end‐stage liver disease and large volume paracentesis (LVP) the accepted management strategy where refractory to medical treatment. In malignant ascites, permanent indwelling peritoneal catheters (PIPC) are an established palliative intervention. The aims are to describe available data using permanent indwelling peritoneal catheters in refractory ascites due to end‐stage liver disease. Methods Using systematic review methodology, databases were searched (MEDLINE, EMBASE, CINAHL [The Cumulative Index to Nursing and Allied Health Literature], Google Scholar and Cochrane Database of Systematic Reviews from inception‐March 2018), for studies combining ascites and palliative care. Inclusion and exclusion criteria were applied to results. Results Following initial and updated searches, 225 studies were identified for full text review, 18 were eligible for final analysis. The studies displayed heterogeneity in design, reported on different indwelling catheters and were overall of low quality. Only one pilot randomised controlled trial was identified, of PIPC versus LVP, recruiting one patient into each arm. Technical insertion success was 100%, with low rates of non‐infectious complications (<12%), none life threatening. Rates of bacterial peritonitis were not unacceptably high (12.7%), considering this was an end‐stage liver disease population and only a minority utilising long‐term prophylactic antibiotics. Only one study attempted quality‐of‐life assessments; none addressed potential health economic benefits. Conclusions Despite lack of well‐designed studies, preliminary data suggests low significant complication rates; however safety and efficacy of permanent indwelling peritoneal catheters in end‐stage liver disease remains to be confirmed. Further prospective randomised controlled trials are warranted, potentially translating permanent indwelling peritoneal catheters into improved palliative care in end‐stage liver disease.

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Section: Discussionmentioning

confidence: 99%

Permanent indwelling peritoneal catheters for palliation of refractory ascites in end‐stage liver disease: A systematic review

Macken

Hashim

Mason

et al. 2019

Liver International

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“…507 And, the portrayal may in itself be insufficient to suggest that ACA benefits are earned; not just beneficiaries' work history, but payroll taxes, help generate this view of Social Security and Medicare. 508,509,510 If the ACA's beneficiaries-its ''consumers'' 511 -are politically dormant, then the ACA may, like Medicaid, 512,513,514 derive political strength from the ''producer'' side of its constituency 515 -the health care industry. 516,517,518 But, ''divisions between health-care producers and consumers.…”

Section: Portrayals and Beneficiary Political Engagementmentioning

confidence: 99%

Are press depictions of Affordable Care Act beneficiaries favorable to policy durability?

Chattopadhyay

2015

Politics and the Life Sciences

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ABSTRACT. Background: If successfully implemented and enduring, the Affordable Care Act (ACA) stands to expand health insurance access in absolute terms, reduce inter-group disparities in that access, and reduce exposure to the financial vulnerabilities illness entails. Its durability-meaning both avoidance of outright retrenchment and fidelity to its policy aims-is thus of scholarly interest. Past literature suggests that social constructions of a policy's beneficiaries may impact durability.Questions: This paper first describes media portrayals of ACA beneficiaries with an eye toward answering three descriptive questions: (1) Do portrayals depict beneficiaries as economically heterogeneous? (2) Do portrayals focus attention on groups that have acquired new political relevance due to the ACA, such as young adults? (3) What themes that have served as messages about beneficiary ''deservingness'' in past social policy are most frequent in ACA beneficiary portrayals? The paper then assesses how the portrayal patterns that these questions uncover may work both for and against the ACA's durability, finding reasons for confidence as well as caution. Methods Implications and Conclusions:Existing literature suggests that these portrayal patterns may both support and limit ACA durability. In favor of durability is that ACA beneficiaries are depicted in terms that have been associated with deservingness in past American social policy-particularly being cast as workers and insiders. Yet, the results also give three reasons for caution. First, ACA insurance-losers are also portrayed as deserving. Second, it is unclear how the portrayal patterns found may impact the durability of the ACA's efforts to cut insurance disparities by age, health status, and especially race/ethnicity. Third, portrayals' strong casting of beneficiaries as workers, and limited attention to beneficiaries' economic heterogeneity and to young adults, may do little to help cultivate beneficiary political engagement around the ACA.

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P-146 Shared care liver project

Cited by 2 publications

References 0 publications

Permanent indwelling peritoneal catheters for palliation of refractory ascites in end‐stage liver disease: A systematic review

Permanent indwelling peritoneal catheters for palliation of refractory ascites in end‐stage liver disease: A systematic review

Are press depictions of Affordable Care Act beneficiaries favorable to policy durability?

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