Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Palliative Care Has Multiple Barriers in End-Stage Liver Disease

Key clinical point: Hepatologists and gastroenterologists perceive multiple patient, clinician, and institutional barriers to the use of palliative care and advance care planning discussion in patients with end-stage liver disease.

Major finding: Clinicians affirmed barriers including: cultural factors (95%), competing demands (91%), and limited reimbursement (76%); only 17% said advance care planning discussions happen at the right time.

Study details: Results of a web-based survey sent to 1,238 physicians designed to assess their perceptions of barriers to use of palliative care and timely advance care planning discussions.

Disclosures: Funding for the research came from the National Institutes of Health. The authors had no disclosures or conflicts of interest related to the report.


Ufere NN, et al. Clin Gastroenterol Hepatol. 2019 Mar 15.