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

Recruiting now · Not applicable

Conditions studied: Liver Diseases

In brief

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.

Key facts

Study ID

NCT06068491

Run by

VA Office of Research and Development

People needed

450

Starts

2024-10-01

Expected to finish

2027-09-30

Last updated by the study team

2026-06-25

Who can join

Age: 18 and older, up to 80. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Patients will be between 18 and 80 years of age
• Patients must be Veterans
• Patients must have been in care at one of the recruiting sites with 1 or more encounters in primary care or GI/Hepatology in the last 24 months
• Patients must have advanced liver disease, defined by ICD-10 codes for cirrhosis complications (ever) or MELD 3.0 >12 or MELD-Na >12 or Fibroscan LSM >20kpa

You may not qualify if…

• Non-Veteran patients
• Patients who do not speak English, do not have access to a telephone or computers, have cognitive impairments, or who are unable to complete a valid informed consent form after three attempts
• Patients who have already made significant progress toward our endpoints: a) with prior history of liver transplantation, or b) on the liver transplant waiting list, or c) had formal evaluation for liver transplantation in the past 3 years
• Patients with very limited life expectancy (advanced cancer, acute-on-chronic liver failure, and hospice patients)
• Patients hospitalized, or in long term facilities or nursing homes at the time they meet inclusion criteria
• Patients with chart diagnosis of uncontrolled mental health or schizophrenia

Where it is running

• Central Arkansas Veterans Healthcare System , Little Rock, AR — Little Rock, Arkansas, United States (enrolling)
• VA Palo Alto Health Care System, Palo Alto, CA — Palo Alto, California, United States (enrolling)
• VA Greater Los Angeles Healthcare System, West Los Angeles, CA — West Los Angeles, California, United States (enrolling)
• Michael E. DeBakey VA Medical Center, Houston, TX — Houston, Texas, United States (enrolling)
• VA Connecticut Healthcare System West Haven Campus, West Haven, CT — West Haven, Connecticut, United States
• VA Long Beach Healthcare System, Long Beach, CA — Long Beach, California, United States
• Miami VA Healthcare System, Miami, FL — Miami, Florida, United States
• VA North Texas Health Care System Dallas VA Medical Center, Dallas, TX — Dallas, Texas, United States

Full record on ClinicalTrials.gov

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