RecruitingNot ApplicableNCT06068491

Veteran-Centered Care for Advanced Liver Disease (Vet-CALD)

Integrating Veteran-Centered Care for Advanced Liver Disease (I-VCALD)

Sponsor

VA Office of Research and Development

Enrollment

450 participants

Start Date

Oct 1, 2024

Study Type

INTERVENTIONAL

Conditions

Liver Diseases

Summary

Advanced liver disease is a serious illness that disproportionately affects Veterans, many of whom hope for curative liver transplantation. However, too few receive a transplant and most continue to suffer from increasing symptoms and hospitalizations. The proposed project uses a whole person, Veteran-centered approach that identifies Veterans with advanced liver disease using a population-based health management system and integrates curative and early supportive care using a telemedicine-based nurse care counselor to (1) discuss patient's understanding of illness severity and prognosis, (2) identify priorities and care preferences and (3) align curative and supportive care options to achieve patient priorities. Study outcomes include changes in (1) rates of consideration for liver transplantation, and (2) completion of serious illness discussions. Findings will inform adaptations to the intervention and facilitators for its dissemination.

Eligibility

Min Age: 18 YearsMax Age: 80 Years

Plain Language Summary

Simplified for easier understanding

This study (Vet-CALD) is testing a veteran-centered care model for US military veterans who have advanced liver disease, such as cirrhosis (severe liver scarring). The goal is to improve the quality of care and quality of life for veterans with serious liver conditions. **You may be eligible if...** - You are a US military veteran between 18 and 80 years old - You have been seen at a participating VA facility in primary care or GI/liver care within the last 2 years - You have advanced liver disease (cirrhosis with complications, or a liver stiffness/MELD score above threshold) - You are able to communicate in English and have access to a phone or computer **You may NOT be eligible if...** - You are not a veteran - You do not speak English or cannot access a telephone or computer - You are unable to provide informed consent Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

OTHERVet-CALD

Vet-CALD Participants will receive the standard of care from their usual VA healthcare provider, plus they will participate in 5 monthly 60-minute care counselor sessions over a period of 6 months via VA Video Connect (VVC) or by telephone. The purpose of care counselor visits is to assess and cultivate the patient's understanding of their illness and identify personal healthcare goals. The counselor will be part of a centralized research care team (hepatologist and supportive care physician) and will work with each patient's usual VA care providers to help tailor treatment plans and education to better align with each patient's understanding of their disease prognosis and their healthcare goals and priorities.