Connect
MJA
MJA

Patient-centred care for cirrhosis: a key role for chronic disease management

Timothy Papaluca and Alexander JV Thompson
Med J Aust 2018; 209 (7) || doi: 10.5694/mja18.00754
Published online: 1 October 2018

Early diagnosis and coordinated care are critical for achieving the best outcomes for patients with liver disease

Chronic liver disease affects more than 6 million Australians, and it is estimated that more than 70 000 have cirrhosis.1 The most common causes are non-alcoholic fatty liver disease, alcohol-related chronic liver disease, and chronic hepatitis B and C. People with cirrhosis are at risk of liver decompensation and liver cancer. More than 7000 Australians die from liver-related causes each year, and another 300 people receive liver transplants.2 Primary liver cancer is the second most rapidly increasing cause of cancer death in Australia.3

The full article is accessible to AMA
members and paid subscribers.
Login to MJA or subscribe now.


  • St Vincent's Hospital, Melbourne, VIC



Competing interests:

No relevant disclosures.

  • 1. Deloitte Access Economics for The Gastroenterological Society of Australia/Australian Liver Association. The economic cost and health burden of liver diseases in Australia. Sydney: Deloitte Access Economics; 2012. http://cart.gesa.org.au/membes/files/Resources/Deloitte_Report_FINAL_06032013.pdf (viewed July 2018).
  • 2. Australia and New Zealand Organ Donation Registry. 2017 ANZOD annual report. Dec 2017. http://www.anzdata.org.au/anzod/v1/AR-2017.html (viewed July 2018).
  • 3. Australian Institute of Health and Welfare. Cancer in Australia 2017 (AIHW Cat. No. CAN 1000; Cancer Series No. 101). Canberra: AIHW, 2017.
  • 4. Ratib S, Fleming KM, Crooks CJ, et al. 1 and 5 year survival estimates for people with cirrhosis of the liver in England, 1998–2009: a large population study. J Hepatol 2014; 60: 282-289.
  • 5. Le S, Spelman T, Chong CP, et al. Could adherence to quality of care indications for hospitalized patients with cirrhosis-related ascites improve clinical outcomes? Am J Gastroenterol 2016; 111: 87-92.
  • 6. Wagner EH, Austin BT, Von Korff M. Organizing care for patients with chronic illness. Milbank Q 1996; 74: 511-544.
  • 7. Roccaforte R, Demers C, Baldassarre F, et al. Effectiveness of comprehensive disease management programmes in improving clinical outcomes in heart failure patients. A meta-analysis. Eur J Heart Fail 2005; 7: 1133-1144.
  • 8. European Association for the Study of the Liver. EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis. J Hepatol 2018; 69: 406-460.
  • 9. Kanwal F, Kramer JR, Buchanan P, et al. The quality of care provided to patients with cirrhosis and ascites in the Department of Veterans Affairs. Gastroenterology 2012; 143: 70-77.
  • 10. Ramachandran J, Hossain M, Hrycek C, et al. Coordinated care for patients with cirrhosis: fewer liver-related emergency admissions and improved survival. Med J Aust 2018; 209: 301-305.
  • 11. Wigg AJ, Chin JK, Muller KR, et al. Cost-effectiveness of a chronic disease management model for cirrhosis: analysis of a randomized controlled trial. J Gastroenterol Hepatol 2018; doi: 10.1111/jgh.14127. [Epub ahead of print].

Author

remove_circle_outline Delete Author
add_circle_outline Add Author

Comment
Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.