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Text Content

 * Scientific Summary
 * The treatment
 * In the News
 * Resources
   * Terms
   * Privacy Policy
   * Compatibility
   * CirrhoCare patient instructions for use
   * Warnings
   * Intended use
 * 



Clinical TrialCirrhoCare
 * Scientific Summary
 * The treatment
 * In the News
 * Resources
   * Terms
   * Privacy Policy
   * Compatibility
   * CirrhoCare patient instructions for use
   * Warnings
   * Intended use



PARTICIPATING NHS TRUSTS ACROSS THE UK

Get in touch to participate in the trial: ccru.cirrhocare@uci.ac.uk


Tweets by CirrhoCareTrial

KNOW MORE ABOUT CIRRHOCARE







Liver disease is the third commonest cause of premature deaths, and mortality of
patients with cirrhosis is increasing year-on-year, with 62,000 years of
working-life lost/year and costs the NHS £4.5 bn/year. Both mortality and the
costs of care are primarily due to ‘liver related complications’ such as
ascites, hepatic encephalopathy (HE), variceal bleeding, and bacterial
infections that warrant urgent hospitalisation, which can last from several days
to weeks with about 30% requiring intensive care. In the 85% patients that
survive, 35-40% are readmitted with a further episode of decompensation within 1
month, (Figure 1). A further 25-30% require regular hospital clinical
interventions.

The current standard of care treatment and rehospitalisation cycle is shown in
Figure 2, along with potential impact of remote monitoring.



Current cirrhosis management is ‘reactive’ when patients present at scheduled
clinic reviews or as emergencies. Moreover, there is significant regional
variation in specialist liver services, highlighted by the UK Liver Atlas 2017
report, underscoring the inequity of current liver care pathways, especially in
regions such as the North-West. Current care treatment plan cannot ensure
cirrhosis patients receive timely and appropriate specialist interventions, nor
have mechanisms to manage complications early in the community, leading to high
treatment costs through late presentations. In addition, feedback from our
Patient and Public Involvement (PPI) workshop study demonstrated that carers
feel poorly supported and unsure from whom to seek help with if complications
are experienced, such as hepatic encephalopathy, this is addition to
over-stretched primary care which struggles to cope with such complex patients.
These patients normally require a regular clinical assessment (every 1-2 weeks)
and even when discharged following a recent admission to hospital, have a
re-admission rate approaching 40% in 8 weeks. The current unmet need is to
institute regular contact with the patient, to avoid further new complications
from cirrhosis developing and hospital admission. The CirrhoCare management
system aims to target this cycle of re-hospitalisations using a novel, digital
therapeutic approach.

THE CIRRHOCARE DEVICE

The CirrhoCare kit is a UKCA-marked, digital-therapeutic-system consisting of
(1) clinical-grade, cirrhosis monitoring sensors and a smartphone-app; (2) a
clinician-facing, decision-facilitating dashboard and (3) CyberLiver’s platform
incorporating hepatic algorithms. Sensors are paired by Bluetooth to the
CirrhoCare app on SIM-enabled smartphones, supplied to patients, for home
monitoring. The digital patient data is transferred to CyberLiver’s platform,
analysed by proprietary algorithms, and presented as actionable insights on the
clinical team’s web-based dashboard. Two-way patient communication, then helps
provide proactive community care, including changing doses of standard
medications like diuretics for fluid overload, and laxatives for encephalopathy.

CirrhoCare addresses the care gap through remote digital monitoring of cirrhosis
and uses actionable insights to help diagnose complications early, allowing
CirrhoCare to provide timely, cost-effective, community interventions. This also
enables specialist liver care in remote geographical locations for Integrated
Care delivery, with additional environmental benefits through less hospital
journeys. This aligns well with the NHS long-term vision to improve outcomes in
chronic conditions, like cirrhosis, through digitally enabled, community-based
care. It also fits within the remit of the NIHR Invention for Innovation i4i
Challenge programme, seeking to provide clinical effectiveness data for a new,
cost-effective care pathway for cirrhosis, that can be rapidly implemented,
given the strides already made in regulatory consultations and CirrhoCare’s
product development.


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