A partnership lead by Flinders University has received funding from the NHMRC to develop a model of care to improve outcomes for patients at risk of liver disease.
The incidence of life-threatening liver disease is rising, driven by alcohol, hepatitis C and obesity-related fatty liver disease.
“With the average age of death of these patients in their mid-50s, this represents a huge loss for individuals, their families and for the community,” said Flinders University Associate Professor Alan Wigg, the lead investigator in the $900,000 combined partnership grant.
“The program we’re developing will aim to address the elephant in the room, that is the economic and health system cost of these patients and their devastating disease,” he says. “It will help to address the multiple and complex barriers that prevent health systems from being able implement many of the highly effective treatments that currently exist.”
Moree than six million Australians suffer from chronic liver disease with more than 7,000 deaths a year – all part of the effects of chronic conditions such as alcohol, hepatitis C and non-alcoholic fatty liver disease (NAFLD).
A previous trial by Flinders University, Flinders Medical Centre and other SA Health researchers showed patients managed under a chronic liver failure program supervised by liver specialists within a coordinated care model had a 48 per cent lower rate of liver-related emergency readmissions and significantly improved (67.7 per cent versus 37.2 per cent) three-year survival than patients managed with standard care.
Not being managed in the hospital with a coordinated care model was independently associated with a 2.5-fold higher risk of mortality, it said.
“We argue that some simple measures, including regular contact with specially trained nurses, can greatly improve outcomes for this chronic condition, which sometimes is poorly understood and mismanaged by patients and their medical and nursing systems,” said Associate Professor Alan Wigg, an FMC gastroenterologist and researcher at the Flinders University.
The NHMRC Partnership Project maximises the impact of research funding through key collaborations that ensure rapid translation of research to the benefit of patients and health-care systems, said Flinders University Deputy Vice-Chancellor (Research) Professor Robert Saint.
“Based on previous pilot studies, expanding this research into a multicentre trial is aiming to result in fewer liver-related emergency department visits and fatalities,” Professor Saint says. “Further research on liver disease, including cirrhosis, could help patients to lead better lives and present less frequently for emergency treatment at our hospitals.”
The new project aims to reduce emergency department admissions, improve mortality rates, give patients more nursing support following discharge and more health information and better general quality of care.
Cirrhosis is a very serious and complex form of liver disease which is often not well managed, added Associate Professor Leon Adams from the Sir Charles Gardiner Hospital in Perth, which is one of the four Australian hospitals involved in the latest research.
“Non-alcoholic fatty liver disease (NAFLD) affects one in four Australian adults and has been increasing in parallel with the rising prevalence of obesity and diabetes in the community,” said Associate Professor Adams.
“A minority of people develop cirrhosis, however this appears increasingly common with NAFLD cirrhosis the fastest growing indication for liver transplantation in Australia and New Zealand.”