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Nurse‐led hepatocellular carcinoma surveillance clinic provides an effective method of monitoring patients with cirrhosis
Author(s) -
Nazareth Saroj,
Leembruggen Nadine,
Tuma Rhoda,
Chen SookLing,
Rao Samarth,
Kontorinis Nick,
Cheng Wendy
Publication year - 2016
Publication title -
international journal of nursing practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.62
H-Index - 55
eISSN - 1440-172X
pISSN - 1322-7114
DOI - 10.1111/ijn.12472
Subject(s) - medicine , hepatocellular carcinoma , cirrhosis , decompensation , retrospective cohort study , attendance , emergency medicine , economics , economic growth
The aim of this study is to examine the acceptability and effectiveness of a nurse‐led hepatocellular carcinoma (HCC) surveillance clinic in high‐risk patients with cirrhosis/advanced fibrosis. Early detection of HCC is associated with better treatment outcomes and improved survival. International guidelines recommend 6‐monthly surveillance of patients at risk of developing HCC. A nurse‐led HCC surveillance protocol was established to support patients in adherence to surveillance protocols. The design used was retrospective document analysis. Retrospective analysis of healthcare records of patients referred to the clinic between August 2009 and December 2015. Extracted data included attendance of clinic visits, blood testing, ultrasound or other imaging, and outcomes. Ultrasound was attended within 6 months in 30.3% of cases and within 7 months in 71.2% of cases. The median time between Nurse‐Led Clinic appointments, ultrasound scans and blood testing did not exceed 9 months. First year FibroScans were attended by 82.9% (63/76) patients; endoscopy was indicated for 42 and attended by 35 (83.3%) patients. Lesions were identified in 16 patients (21.5%) and HCC diagnosed in two patients. One patient died because of HCC and one to sub‐dural haematoma. Nurse‐led HCC surveillance was an effective method of monitoring patients with cirrhosis at high risk of developing HCC. Well‐defined protocols enable timely identification of patients with HCC or hepatic decompensation so that management strategies can be implemented without delay. The potential benefits identified by this study warrant further, rigorous evaluation.