Transitional Care for Patients with Cirrhosis: A Multidisciplinary Care Model for Prevention Complications Post-TIPS

AIM: To evaluate the efficacy of transitional care interventions of multidisciplinary teams for patients with cirrhosis post-TIPS. METHODS: 68 patients undergone TIPS were randomly allocated to control or intervention group. Patients in control group received conventional care, patients in the intervention group received conventional care combined with transitional care. The compliance behavior, incidence of HE and shunt dysfunction, Child-Pugh scores and ammonia of two groups were compared at 1,3,6 and 12 month post-TIPS. RESULTS: Repeated measures analysis of variance showed significant group effects from 1,3,6 and 12 month post-TIPS for compliance behavior scores of the two groups. Intervention group had significant higher compliance behavior scores than control group 1, 3 and 6 month post-TIPS respectively. The incidences of HE the intervention group were significantly lower than control group12 months after TIPS.The incidences of shunt dysfunction in the intervention group were significantly lower than control group 12 months after TIPS. The group effects ,time effects and group*time interaction showed no significant difference in Child-Pugh scores and blood ammonia between the two groups. CONCLUSION: Post-TIPS transitional care interventions increase the accessibility of patients to scientifically informed nursing, significantly improve patients' compliance behavior and health, decrease the incidence of HE and shunt dysfunction. Clinical Trial Number: The study was registered in an independent clinical trial database (www.clinicaltrials.gov; identifier: NCT02877953)( 08/23/2016). Funding Statement: The Xinjiang Shihezi Science and Technology Administration Department provided funding for the study. This work was supported by the Foundation of the Shanghai Public Health Bureau, No. 201740143; and the Project of Medical Key Specialty of Shanghai Municipality, No. ZK2015A22. Declaration of Interests: There are no conflicts of interest. Ethics Approval Statement: The study protocol was approved by the ethical committees for human investigations at the Third Affiliated Hospital of the Medical College, Shi he zi University and by the Local Department of Health and Family Planning Commission. The study protocol also fulfilled the guidelines of Good Clinical Practice in clinical trials.