Patients with advanced cirrhosis often suffer from ascites, a build-up of fluid in the abdomen, leading to severe pain and breathlessness. A new study, REDUCe2, is exploring the use of long-term abdominal drains (LTADs) to improve the quality of life for these patients by allowing them to receive palliative care at home.
Current Palliative Care Limitations
Currently, the standard palliative care for ascites in cirrhosis patients involves repeated hospital admissions for draining the fluid. This procedure, while effective in reducing pain, requires patients to travel to the hospital every 10-14 days, causing discomfort and inconvenience. In contrast, cancer patients with ascites often receive LTADs, which remain in place for months, allowing community nurses or caregivers to drain smaller amounts of fluid more frequently at home.
The REDUCe2 Study: Bringing Care Home
The REDUCe2 study aims to determine if LTADs can be safely and effectively used for cirrhosis patients. The study will assess the safety, infection risk, and overall impact on quality of life of LTADs delivered at home for this patient group. The research involves 310 participants across 35 sites in the UK. Participants are recruited and randomized during routine clinic visits by the hospital Hepatology team.
Agile Research Delivery Support
Delivering the LTAD intervention requires follow-up visits in the patient's home, which necessitates out-of-hospital support. Agile Research Delivery teams are providing this support, enabling study activities such as recruitment, screening, consenting, intervention, follow-up, and data entry to occur in the community.
Clare Aitken, the Agile Research Delivery Team Manager, explains, “Since our inception, three years ago, we’ve delivered multiple studies in the community which has enabled us to develop processes and hone our approaches. We can confidently support study activities outside of the hospital.”
Potential Impact
If successful, the REDUCe2 study could significantly improve palliative care for individuals with long-term liver disease, reducing the burden of repeated hospital visits and enhancing their overall quality of life. Liver disease deaths in England have increased by over 250% since 1971, underscoring the urgent need for improved palliative care options.
