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PalC/Resources/Learning Materials/Doctors/[Journal article] Examining the implementation of home-based palliative care for patients with end-stage liver disease (HoPE): a protocol for a feasibility study
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Year 2025
October 2025

[Journal article] Examining the implementation of home-based palliative care for patients with end-stage liver disease (HoPE): a protocol for a feasibility study

31 Oct 2025

Authors: Chung Yau Nah, WanFen Yip, Kalaiyarasi Kaliyaperumal, Sek Hwee Yung, Siew Chin Chia, Allyn Hum

Published in: BMJ Open. Published online: 16 Oct 2025. DOI: 10.1136/bmjopen-2025-103784. PMID: 41101957; PMCID: PMC12530434.

Summary points:

  1. Patients with end-stage liver disease (ESLD) face severe complications, high symptom burden, and significant frailty, leading to poor health-related quality of life. With a median survival under two years and limited access to curative transplantation, their condition parallels other advanced chronic diseases in symptom prevalence and decline.
  2. Home-based palliative care can reduce suffering, hospital visits, and support preferred home deaths, but its use in end-stage liver disease (ESLD) remains unexplored. In Singapore, although referrals to home palliative care have grown over time, this expansion has largely been limited to patients with advanced renal disease, thus highlighting the need for research to expand access for those with ESLD.
  3. This mixed methods, single centre study primarily aims to assess the implementation, feasibility, and acceptability of home palliative care for patients with end-stage liver disease (ESLD). Secondarily, it examines changes in patients’ quality of life, symptoms, advance care planning, depression, caregiver burden, and healthcare utilization.

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