Chronic liver disease, platelet transfusion & quality of life - a british liver trust patient-survey

IntroductionFor patients with chronic liver disease, thrombocytopenia is a common complication that impacts on management of cirrhosis and has implications for planned surgical/diagnostic procedures due to an increased risk of bleeding. Platelet transfusion (PT) has been the standard of care for management of thrombocytopenia. There is a need to better understand the views and experiences of UK patients with advanced disease and how their condition, and requirements for PT, affect quality of life.MethodThe British Liver Trust (BLT) undertook a patient survey between December 2020 and February 2021. Patients were invited to participate via BLT channels (monthly newsletter;patient support groups) answering 30 questions (anonymously) via the Survey Monkey platform. The survey was conducted independently by the BLT, supported by an educational grant from Shionogi.ResultsA total of 121 patients completed the survey. Alcohol related liver disease was the most commonly reported primary liver disease (28%);63% of respondents were female;73% were aged over 45 years, and 51% have been told they may require a liver transplant in the future. A large proportion (69%) of patients reported that liver disease sometimes affects their ability to think clearly. Half of responders recorded having to take time off work for liver-related hospital appointments;40% travel > 25 miles to their liver centre/hospital for routine appointments, and 55% said that the COVID-19 pandemic had led to procedures related to their liver disease being cancelled. Many patients (62%) reported that healthcare professionals (HCPs) have difficulties inserting a needle into a vein and 40% noted that they have needed a dental extraction since being diagnosed. Almost a third (30%) have required a PT at some time, and of those, 70% had to stay in hospital the night before the PT. Patients reported that the reasons for needing a PT were typically well-explained. Among recipients of PT, 42% said they felt unwell during or post the PT. Following completion of the survey, 33 patients provided consent for voluntary follow-up and supplementary questions from the BLT.ConclusionsA survey of patients with chronic liver disease highlights that the COVID-19 pandemic has impacted on and delayed planned procedures, and identifies that both chronic liver disease, and the requirement for PT, pose a burden to patients that may adversely affect quality of life.