Journal of Gastrointestinal & Digestive System
Open Access

Abstract

Introduction & Aim: Patients with chronic illness often have chronic pain. In Edmonton, a non-cancer palliative care clinic has been instituted since 2013 in order to address symptom management in cirrhosis patients in the last years of life. Of the 40 patients seen to date, over 65% of them have had significant pain issues (pain scores of over 4 on a 10 point scale). Many of these patients were initiated on pharmacologic pain management, based on current pain management regimens in the literature. Through evaluation of success of treatment (defined as a decrease of 2 points on the 10 point scale), it was determined that many patients did not respond well to medical therapy, due to a variety of reasons. Within the clinic, mindfulness principles were encouraged through mobile technology, internet based and local mindfulness resources. Methods: A total of 15 patients, representing ~10% of eligible patients approached and were enrolled with consent. Patient inclusion criteria were: Cirrhosis diagnosis; adults (â�?¥18 years of age); significant symptom burden as per the Edmonton Symptom Assessment Scale (ESAS, score of â�?¥4 out of 10); and absence of uncontrolled hepatic encephalopathy, psychosis and bipolar disorder or suicidal intent. The online intervention were delivered by eMindful Inc. for over 3 weeks consisting of a live trainer providing video instruction (2 hrs/wk) complemented by daily individual practice (45 min/d). Results: Data presented as results included: Stage of liver disease, medications and symptom burden. Adherence, completion and success of the MBSR program were discussed.

Biography

Amanda J Brisebois is an Internal Medicine and Palliative Care Specialist from Edmonton, Alberta, Canada. She has been practicing for 17 years, and has been focusing on the Integration of Palliative Care Principles in care of patients with chronic illness for the past 5 years. She is the current Facility Chief of Medicine at the Grey Nuns Hospital and also an Associate Clinical Professor at the University of Alberta. She has won numerous teaching awards, as well as grants to undertake her current work.

Email: amandab@ualberta.ca