Optimizing medication management for patients with cirrhosis: Evidence-based strategies and their outcomes.

Liver International : Official Journal of the International Association for the Study of the Liver
Mary J ThomsonElliot B Tapper

Abstract

Cirrhosis is a morbid condition associated with frequent hospitalizations and high mortality. Management of cirrhosis requires complex medication regimens to treat underlying liver disease, complications of cirrhosis and comorbid conditions. This review examines the complexities of medication management in cirrhosis, barriers to optimal medication use, and potential interventions to streamline medication regimens and avoid medication errors. A literature review was performed by searching PUBMED through December 2017 and article reference lists to identify articles relevant to medication management, complications, adherence, and interventions to improve medication use in cirrhosis. The structural barriers in cirrhosis include sheer medication complexity related to the number of medications and potential for cognitive impairment in this population, faulty medication reconciliation and limited adherence. Tested interventions have included patient self-education, provider driven patient education, intensive case management including medication blister packs and smartphone applications. Initiatives are needed to improve patient, caregiver and provider education on appropriate use of medications in patients with cirrhosis. A multidis...Continue Reading

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Citations

Dec 8, 2019·Expert Opinion on Drug Metabolism & Toxicology·Rianne A WeersinkSander D Borgsteede
May 8, 2019·Hepatology Communications·Kelly L HaywardElizabeth E Powell
Sep 12, 2020·PloS One·Shari S RogalTimothy R Morgan
Nov 10, 2020·Hepatology Communications·Kelly L Hayward, Rianne A Weersink
Sep 11, 2020·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Mary J ThomsonElliot B Tapper
Jun 15, 2021·Mayo Clinic Proceedings·Carlos Lago-HernandezSiddharth Singh

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