{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T07:35:50Z","timestamp":1772177750018,"version":"3.50.1"},"reference-count":38,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"unspecified","delay-in-days":57,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Pall Supp Care"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1478951526101795_sec1a\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Patients with advanced liver disease (ALD) may benefit from the early integration of supportive care toward the end of life. Engagement with supportive and palliative care could decrease disease-related distress and alleviate pressure on the health system. This trial evaluated whether a transdisciplinary supportive care model, aligned with standard care and guided by patient- and carer-identified needs, could optimize health service utilization and outcomes for patients and carers living with ALD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951526101795_sec2b\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A 90-day multicenter, mixed-methods pilot randomized controlled trial,\n                      <jats:italic>\u201cLiver Life,\u201d<\/jats:italic>\n                      was conducted at 1 regional tertiary and 1 rural referral hospital in NSW, Australia. The intervention group received patient- and carer-centered supportive care interventions during 5 scheduled allied health-led outpatient visits, alongside ongoing standard care. This paper reports health service utilization and associated costs, and participant-reported measures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951526101795_sec3c\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over 90 days, emergency department presentations were reduced by 66% (incidence rate ratio: 0.34 [0.13\u20130.80]), and hospital admissions by 64% (incidence rate ratio: 0.36 [0.12\u20130.98]). Intervention patients were 5 times more likely to have more days \u201calive and out of hospital\u201d than those receiving standard care alone (odds ratio: 5.34 [1.43\u201322.1]). As a result, the overall cost of health service use per intervention patient was less than half that of standard care alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951526101795_sec4d\">\n                    <jats:title>Significance of results<\/jats:title>\n                    <jats:p>\n                      The\n                      <jats:italic>Liver Life<\/jats:italic>\n                      trial demonstrated the feasibility, acceptability, efficacy, and potential cost savings of a transdisciplinary supportive care model for ALD patients and their caregivers. Future research should investigate the sustainability and transferability of this approach to other populations and other chronic diseases.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1478951526101795","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:36:15Z","timestamp":1772170575000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating a transdisciplinary supportive care model for advanced liver disease: Results of the\n                    <i>Liver Life<\/i>\n                    pilot randomized controlled trial (RCT)"],"prefix":"10.1017","volume":"24","author":[{"given":"Sarah","family":"Pullen","sequence":"first","affiliation":[{"name":"Hunter New England (HNE) Health"},{"name":"Hunter Medical Research Institute (HMRI)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8512-3901","authenticated-orcid":false,"given":"Tazeen","family":"Majeed","sequence":"additional","affiliation":[{"name":"Hunter Medical Research Institute (HMRI)"},{"name":"University of Newcastle"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Russo","sequence":"additional","affiliation":[{"name":"Hunter New England (HNE) Health"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary-Anne","family":"Dieckmann","sequence":"additional","affiliation":[{"name":"Hunter New England (HNE) Health"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Oldmeadow","sequence":"additional","affiliation":[{"name":"Hunter Medical Research Institute (HMRI)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivia","family":"Wynne","sequence":"additional","affiliation":[{"name":"University of Newcastle"},{"name":"Hunter Medical Research Institute (HMRI)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Kuhne","sequence":"additional","affiliation":[{"name":"Hunter Medical Research Institute (HMRI)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane","family":"Kerr","sequence":"additional","affiliation":[{"name":"Hunter New England (HNE) Health"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9800-1308","authenticated-orcid":false,"given":"John","family":"Attia","sequence":"additional","affiliation":[{"name":"University of Newcastle"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katie","family":"Wynne","sequence":"additional","affiliation":[{"name":"Hunter Medical Research Institute (HMRI)"},{"name":"University of Newcastle"},{"name":"Hunter New England (HNE) Health, Diabetes & Endocrinology"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"S1478951526101795_ref36","doi-asserted-by":"publisher","DOI":"10.1097\/HC9.0000000000000066"},{"key":"S1478951526101795_ref14","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-3400259"},{"key":"S1478951526101795_ref25","unstructured":"NSW Health (2019) Access procedures for advance care planning on My Heath Record. 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