Effectiveness of palliative care for the management of end-stage liver disease: a systematic review protocol.

OBJECTIVE

The aim of this systematic review will be to evaluate the effectiveness of palliative care for treating adults with end-stage liver disease (ESLD), focusing on outcomes such as quality of life, quality of care, symptom burden, and patient satisfaction.

INTRODUCTION

ESLD is a critical health issue, characterized by various devitalizing symptoms that negatively affect quality of life for patients. Palliative care, which is a specialty used to alleviate pain and control other manifestations of the disease, has been suggested across various studies for the management of quality of life and symptom burden in patients with ESLD.

ELIGIBILITY CRITERIA: This review will include studies focusing on the use of palliative care for adults (≥18 years) with ESLD. Papers that compare palliative care with usual care or placebo will also be included.

METHODS

The review will follow the JBI methodology for systematic reviews of effectiveness. PubMed, Embase (Ovid), Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL (EBSCOhost), Scopus, and Web of Science will be searched for published studies. Sources to be searched for unpublished literature will include Google Scholar, ProQuest Dissertations and Theses Global, Shodhganga, MedNar, OpenGrey, and the WHO International Clinical Trials Registry Platform. Two independent reviewers will assess titles, abstracts, and full-text papers against the inclusion criteria. A third reviewer will resolve any discrepancies. Standardized JBI appraisal tools will be used to critically appraise eligible studies. Two independent reviewers will extract data. Meta-analysis will be conducted for outcomes, where feasible. If a meta-analysis cannot be conducted, the findings will be reported in a narrative format, adhering to the Synthesis Without Meta-analysis guidelines. Certainty of evidence will be reported using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.

REVIEW REGISTRATION: PROSPERO CRD42024586855.