Abstract
Objective Exploring the unmet needs of
patients awaiting liver transplantation remains
largely unexplored and with no established
multicomponent support mechanisms currently
available, identifying these needs could provide
better, tailored support. This study explores
the experiences of patients, caregivers and
clinicians, highlighting unmet needs and using
these to inform support strategies during the
pre-transplant period.
Methods A qualitative study using focus groups.
Participants: patients, caregivers and clinicians
with experience of awaiting liver transplantation
and/or receiving a transplantation. Focus groups
were audio-recorded, transcribed on Microsoft
Teams and verified by the lead author. The data
were analysed using reflexive thematic analysis.
Results A total of 52 participants were involved
in the study: 23 patients, 10 caregivers and
19 clinicians, across 11 focus groups. Reflexive
thematic analysis identified six overarching
themes and 16 subthemes that impacted
patients awaiting liver transplantation. Six
themes included: (1) Sequelae of awaiting
liver transplantation, (2) Current management
strategies awaiting liver transplantation,
(3) Perceived benefits of prehabilitation, (4)
Essential considerations for targeted support,
(5) Strategies to optimise engagement and (6)
Opportunities and challenges of remote delivery.
Conclusion This study highlights critical
unmet needs among patients awaiting liver
transplantation, emphasising the necessity for
flexible, individualised and remotely delivered
interventions that go beyond exercise support
to include nutrition, psychological and peer
support, financial and social resources and
comprehensive education. Clinician endorsement
and regular check-ins delivering behaviour
change support may improve engagement,
though variability in disease progression will
continue to pose challenges.
patients awaiting liver transplantation remains
largely unexplored and with no established
multicomponent support mechanisms currently
available, identifying these needs could provide
better, tailored support. This study explores
the experiences of patients, caregivers and
clinicians, highlighting unmet needs and using
these to inform support strategies during the
pre-transplant period.
Methods A qualitative study using focus groups.
Participants: patients, caregivers and clinicians
with experience of awaiting liver transplantation
and/or receiving a transplantation. Focus groups
were audio-recorded, transcribed on Microsoft
Teams and verified by the lead author. The data
were analysed using reflexive thematic analysis.
Results A total of 52 participants were involved
in the study: 23 patients, 10 caregivers and
19 clinicians, across 11 focus groups. Reflexive
thematic analysis identified six overarching
themes and 16 subthemes that impacted
patients awaiting liver transplantation. Six
themes included: (1) Sequelae of awaiting
liver transplantation, (2) Current management
strategies awaiting liver transplantation,
(3) Perceived benefits of prehabilitation, (4)
Essential considerations for targeted support,
(5) Strategies to optimise engagement and (6)
Opportunities and challenges of remote delivery.
Conclusion This study highlights critical
unmet needs among patients awaiting liver
transplantation, emphasising the necessity for
flexible, individualised and remotely delivered
interventions that go beyond exercise support
to include nutrition, psychological and peer
support, financial and social resources and
comprehensive education. Clinician endorsement
and regular check-ins delivering behaviour
change support may improve engagement,
though variability in disease progression will
continue to pose challenges.
| Original language | English |
|---|---|
| Number of pages | 10 |
| Journal | Frontline Gastroenterology |
| Early online date | 20 Nov 2025 |
| DOIs | |
| Publication status | Published online - 20 Nov 2025 |
Data Access Statement
All data relevant to the study are included in the article or uploaded as supplementary information..Funding
This work was supported by the Northern Ireland Public Health Agency (Research and Development Division) (Reference: EAT/5651/20), as part of the Doctoral Fellowship Scheme and Belfast Health and Social Care Trust Research Charitable Fund Department.
