Standardized Patient Education for Decompensated Cirrhotic Patients and Impact on Clinician Satisfaction

Abstract

Chronic liver disease and cirrhosis are the 12th leading cause of death in the United states and account for 12.5 deaths per 100,000 individuals (Murphy, Xu, Kochanek, Curtin, & arias, 2017). the diagnosis of cirrhosis marks the beginning of end-stage liver disease and the onset of portal hypertension along with associated complications including ascites, variceal bleeding, and encephalopathy (Runyon, 2013). these complications impair physical stability, diminish the patient's quality of life, and increase the risk of mortality.Evidence-based treatment guidelines for the management of ascites in the setting of cirrhosis include sodium restriction, diuretics, therapeutic paracentesis, and, if these are unsuccessful, transjugular intrahepatic portosystemic shunt (tIPs) (Fowler, 2013;Runyon, 2013). Patient adherence to sodium restriction and outpatient diuretic therapy are the mainstay treatments of the long-term control of ascites and, subsequently, preventing inpatient admissions and the need for invasive procedures such as tIPs or repeat paracentesis (Kuo, Haftek, & Lai, 2017;Runyon, 2013). Despite these known treatments, patients continue to present to outpatient clinics, urgent care, and the emergency department with symptoms of ascites (Beg, Curtis, & shariff, 2016;Kuo et al., 2017; Morales et al., 2018).In prior studies, researchers demonstrated that focused disease self-management educational interventions provided in the cirrhotic population have been effective in improving patient knowledge (Beg et al.,