{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T03:40:35Z","timestamp":1792122035901,"version":"4.4.0"},"reference-count":46,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,6,1]],"date-time":"2020-06-01T00:00:00Z","timestamp":1590969600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000377","name":"Dunhill Medical Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000377","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Palliative care remains suboptimal in end\u2010stage liver disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To inform a definitive study, we assessed palliative long\u2010term abdominal drains in end\u2010stage liver disease to determine recruitment, attrition, safety\/potential effectiveness, questionnaires\/interview uptake\/completion and make a preliminary cost comparison.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A 12\u2010week feasibility nonblinded randomised controlled trial comparing large\u2010volume paracentesis vs long\u2010term abdominal drains in refractory ascites due to end\u2010stage liver disease with fortnightly home visits for clinical\/questionnaire\u2010based assessments. Study success criteria were attrition not &gt;50%, &lt;10% long\u2010term abdominal drain removal due to complications, the long\u2010term abdominal drain group to spend &lt;50% ascites\u2010related study time in hospital vs large\u2010volume paracentesis group and 80% questionnaire\/interview uptake\/completion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 59 eligible patients, 36 (61%) were randomised, 17 to long\u2010term abdominal drain and 19 to large\u2010volume paracentesis. Following randomisation, median number (IQR) of hospital ascitic drains (long\u2010term abdominal drain group vs large\u2010volume paracentesis group) were 0 (0\u20101) vs 4 (3\u20107); week 12 serum albumin (g\/L) and serum creatinine (\u03bcmol\/L) were 29 (26.5\u201032.5) vs 30 (25\u201035) and 104.5 (81\u2010115.5) vs 127 (63\u2010158) respectively. Total attrition was 42% (long\u2010term abdominal drain group 47%, large\u2010volume paracentesis group 37%). Median (IQR) fortnightly community\/hospital\/social care ascites\u2010related costs and percentage study time in hospital were lower in the long\u2010term abdominal drain group, \u00a3329 (253\u2010580) vs \u00a3843 (603\u20101060) and 0% (0\u20100.74) vs 2.75% (2.35\u20103.84) respectively. Self\u2010limiting cellulitis\/leakage occurred in 41% (7\/17) in the long\u2010term abdominal drain group vs 11% (2\/19) in the large\u2010volume paracentesis group; peritonitis incidence was 6% (1\/17) vs 11% (2\/19) respectively. Questionnaires\/interview uptake\/completion were \u226580%; interviews indicated that long\u2010term abdominal drains could transform the care pathway.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The REDUCe study demonstrates feasibility with preliminary evidence of long\u2010term abdominal drain acceptability\/effectiveness\/safety and reduction in health resource utilisation.<\/jats:p><jats:p>Trial registration: ISRCTN30697116, date assigned: 07\/10\/2015.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.15802","type":"journal-article","created":{"date-parts":[[2020,6,1]],"date-time":"2020-06-01T15:18:22Z","timestamp":1591024702000},"page":"107-122","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":63,"title":["Randomised clinical trial: palliative long\u2010term abdominal drains vs large\u2010volume paracentesis in refractory ascites due to cirrhosis"],"prefix":"10.1111","volume":"52","author":[{"given":"Lucia","family":"Macken","sequence":"first","affiliation":[{"name":"Brighton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Bremner","sequence":"additional","affiliation":[{"name":"Brighton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Gage","sequence":"additional","affiliation":[{"name":"Guildford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morro","family":"Touray","sequence":"additional","affiliation":[{"name":"Guildford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Williams","sequence":"additional","affiliation":[{"name":"Guildford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Crook","sequence":"additional","affiliation":[{"name":"Brighton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Mason","sequence":"additional","affiliation":[{"name":"Brighton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debbie","family":"Lambert","sequence":"additional","affiliation":[{"name":"Brighton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine J.","family":"Evans","sequence":"additional","affiliation":[{"name":"Brighton UK"},{"name":"London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max","family":"Cooper","sequence":"additional","affiliation":[{"name":"Brighton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Timeyin","sequence":"additional","affiliation":[{"name":"Brighton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shani","family":"Steer","sequence":"additional","affiliation":[{"name":"Brighton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Austin","sequence":"additional","affiliation":[{"name":"Brighton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"Parnell","sequence":"additional","affiliation":[{"name":"Brighton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam J.","family":"Thomson","sequence":"additional","affiliation":[{"name":"Worthing UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Sheridan","sequence":"additional","affiliation":[{"name":"Plymouth UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Wright","sequence":"additional","affiliation":[{"name":"Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Isaacs","sequence":"additional","affiliation":[{"name":"Blackpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Hashim","sequence":"additional","affiliation":[{"name":"Brighton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7021-8409","authenticated-orcid":false,"given":"Sumita","family":"Verma","sequence":"additional","affiliation":[{"name":"Brighton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,6]]},"reference":[{"key":"e_1_2_15_2_1","unstructured":"Public Health England.The 2nd Atlas of variation in risk factors and healthcare for liver disease in England. 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