Professor
Aleksander Krag
Department of Medical Gastroenterology, Odense University Hospital
Project management | ||
Project status | Closed | |
Data collection dates | ||
Start | 01.01.2015 | |
End | 01.06.2015 | |
For decades beta-blockers have been a cornerstone in the standard treatment of patients with liver cirrhosis and esophageal varices. However, in recent years questions regarding the safety and possible contraindications in advanced cirrhosis have been raised based on observational studies, consequently the complexity of the treatment of cirrhotic patients has increased. No guidelines take these possible contraindications into account and the decision depends on the individual clinician. This survey aims to unravel clinical practice within this field.
Patients with cirrhosis may develop oesophegal varices, which can be followed by complications such as bleeding due to the increased portal pressure. Recommended standard treatment relates to lowering of the portal pressure, generally this goal is obliged by prescribing beta-blockers.
However, new studies question the safety of beta-blockers in advanced cirrhosis. Beta-blockers should be considered only temporary, due to the risk of decreased organ perfusion on late-state cirrhosis and therefore a "window-hypothesis" has been suggested for treatment with beta-blockers. In this context a lot of possible contraindications have been investigated and discussed with various outcome and conclusions.
Due to this uncertainty, it is to be expected that physicians will act differently when considering contraindications, resulting in different treatment due to the physician subjective opinion. Before implementing contraindications in treatment-guidelines, unambiguousness is mandatory which can only be obtained with a randomized controlled trial (RCT).
The aim of this survey is to describe how this new knowledge, affect treatment and perception among this group of patients.
The survey "Beta-blockers in advanced cirrhosis: A local and global survey to unravel impact of conflicting evidence on clinical practice" is structured upon the before mentioned possible contraindications and include questions regarding how the physicians act when deciding "to block or not to block".
The survey applies to physicians who treat patients with cirrhosis.
It will be send electronically to:
The purpose of the survey is to collect information of how physicians treat cirrhotic patients.
Department of Medical Gastroenterology, Odense University Hospital
Department of Liver and Biliopancreatic disorders, University Hospitalt Leuven, Belgium