AJMC Stakeholder Summit: Advancing Hepatic Encephalopathy Management

Dr. Derek van Amerongen introduces a panel discussing hepatic encephalopathy (HE), noting that 30-40% of cirrhotic patients develop overt HE.

Dr. Arun Jesudian explains that hepatic encephalopathy (HE) is a reversible neuropsychiatric syndrome in cirrhosis patients, often undiagnosed due to asymptomatic progression.

The panel explains that diagnosing hepatic encephalopathy (HE) involves excluding other potential causes of mental status changes, with HE ranging from subtle to severe impairment.

HE poses significant clinical and economic burdens, with admissions costing tens of thousands of dollars and frequent readmissions, impacting patients, caregivers, and the healthcare system.

Optimal HE management includes early diagnosis, addressing precipitating factors, guideline-based treatments, unrestricted medication access, and comprehensive patient support to prevent hospitalizations and improve outcomes.

The panelists deliberate on optimal long term care strategies for HE to sustain patient lucidity and to prevent rehospitalizations.

The panel discuss strategies for integrating AASLD guidelines for HE into clinical practice and highlight the need for healthcare systems and providers to prioritize improved management of this critical disease state.

Key opinion leaders explore strategies for identifying precipitating factors of HE, underscoring the importance of patient and caregiver education to mitigate treatment-related side effects and reduce recurrent hospitalizations.

Experts highlight the critical importance of seamless transitions of care in managing patients with HE and the necessity of effective communication between inpatient and outpatient healthcare providers.

Panelists discuss the critical role of collaboration in hepatology care, emphasizing patient education and thorough follow-up appointments to ensure medication adherence and minimize readmissions.

The panel navigates insurance coverage during patient discharge for HE and the significance of ensuring medication access post-discharge.

The panel uses a case study to discuss identifying and diagnosing HE and some considerations of patient-specific characteristics.

Dr. Jesudian and Dr. Amin discuss improving outcomes in hepatic encephalopathy (HE) through provider-payer collaboration, stressing accurate diagnosis, medication access, and follow-up care. They highlight challenges with ICD-10 coding and advocate for alignment among stakeholders and coordinated efforts such as clinical pathways and enhanced communication to reduce costs and enhance patient care.

The panel emphasizes the need for alignment and collaboration to enhance outcomes in hepatic encephalopathy (HE), stressing the importance of implementation science, APP education, and proactive screening for chronic liver disease and cirrhosis. They advocate for interdisciplinary meetings to optimize patient care and medication management, highlighting the increasing prevalence of complications related to cirrhosis in the US.