Home Monitoring in Encephalopathy (The d-LIVER HoME trial) v1.0

  • Research type

    Research Study

  • Full title

    Home Monitoring in Encephalopathy (The d-LIVER HoME trial)

  • IRAS ID

    156104

  • Contact name

    James G Orr

  • Contact email

    james.orr@ncl.ac.uk

  • Sponsor organisation

    Research and Development

  • Research summary

    Hepatic Encephalopathy (HE) is a complication of advanced liver disease which can cause confusion or decreased conscious level. HE frequently results in emergency admission to hospital and is associated with severely impaired Health Related Quality of Life (HRQOL). The first-line treatment of HE is the laxative lactulose which works by increasing stool frequency resulting in a reduction in absorption of toxins produced by bacteria in the gut. However, in spite of this treatment, HE often worsens resulting in readmission to hospital. One potential contributing factor is that large doses of lactulose can be unpleasant for patients to take meaning that compliance with the drug may be poor, particularly when there appears to be no evidence of ongoing confusion.

    This pilot evaluation aims to investigate the use of a home monitoring system to direct lactulose therapy in patients with a previous episode of overt HE. A simple cognitive test will be carried out by patients on a daily basis and stool frequency will be recorded using a tablet PC interface. These two parameters will be used to adjust lactulose dose where appropriate. In situations where there is evidence of increasing confusion which is not responding to treatment, intervention by a clinician will be initiated.

  • REC name

    North East - Newcastle & North Tyneside 1 Research Ethics Committee

  • REC reference

    14/NE/1114

  • Date of REC Opinion

    29 Sep 2014

  • REC opinion

    Further Information Favourable Opinion