Veteran-Centered Care for Advanced Liver Disease (Vet-CALD)

This study is testing a program called Vet-CALD for Veterans with advanced liver disease. This program aims to improve care by helping you understand your illness, identify your priorities, and align your care options, including liver transplantation, with your goals. Participants will receive standard VA care plus five monthly 60-minute sessions with a care counselor over six months, either by video or phone. To join, you must be a Veteran between 18 and 80 years old, have received care at a recruiting VA site recently, and have advanced liver disease. The study will measure if there's more documentation in your medical record about considering liver transplantation and having goals of care conversations. The current recruitment status is unclear.

Study design
This is an interventional study planning to enroll 450 participants. It uses a randomized controlled study design.
What's involved
You would participate in five monthly 60-minute care counselor sessions over a period of six months via VA Video Connect (VVC) or by telephone.
Compensation
Not stated in the trial record.
Follow-up
The study will track changes in your medical records at 6 and 12 months.

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NCT06068491

Veteran-Centered Care for Advanced Liver Disease (Vet-CALD)

Recruiting
NAAges 18–80InterventionalHealth services
VA Office of Research and Development
~450 participants
Updated 2026-06-25 on ClinicalTrials.gov
What's tested:Vet-CALD

At a glance

Recruiting sites
4 of 8 listed sites are recruiting right now
RecruitingSuspended, closed, or not yet open
What they're measuring
EHR documentation of consideration for liver transplantation change
Measured over 6 and 12 months
+1 more outcome measured
Liver Diseases

NCT06068491

Where you'd take part

This study runs at 8 sites. They're the same protocol — you choose where, and that choice sets who your contact draft is addressed to.

  • Central Arkansas Veterans Healthcare System , Little Rock, AR

    Little Rock, Arkansasstudy coordinator listed

    Recruiting

  • Miami VA Healthcare System, Miami, FL

    Miami, Floridastudy coordinator listed

    Not yet recruiting

  • Michael E. DeBakey VA Medical Center, Houston, TX

    Houston, Texasstudy coordinator listed

    Recruiting

  • VA Connecticut Healthcare System West Haven Campus, West Haven, CT

    West Haven, Connecticutstudy coordinator listed

    Not yet recruiting

  • VA Greater Los Angeles Healthcare System, West Los Angeles, CA

    West Los Angeles, Californiastudy coordinator listed

    Recruiting

  • VA Long Beach Healthcare System, Long Beach, CA

    Long Beach, Californiastudy coordinator listed

    Not yet recruiting

  • VA North Texas Health Care System Dallas VA Medical Center, Dallas, TX

    Dallas, Texasstudy coordinator listed

    Not yet recruiting

  • VA Palo Alto Health Care System, Palo Alto, CA

    Palo Alto, Californiastudy coordinator listed

    Recruiting

Sites open and close at different times, so the status above is per site — it can differ from the study's overall status.

  • Fasiha Kanwal, MD MSHS · PRINCIPAL_INVESTIGATOR · Michael E. DeBakey VA Medical Center, Houston, TX
  • Anne M Walling, MD PhD · PRINCIPAL_INVESTIGATOR · VA Greater Los Angeles Healthcare System, West Los Angeles, CA
  • Steven M. Asch, MD MPH · PRINCIPAL_INVESTIGATOR · VA Palo Alto Health Care System, Palo Alto, CA

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Eligibility criteria

Inclusion

Patients will be between 18 and 80 years of age
Patients must be Veterans
Patients must have been in care at one of the recruiting sites with 1 or more encounters in primary care or GI/Hepatology in the last 24 months
Patients must have advanced liver disease, defined by ICD-10 codes for cirrhosis complications (ever) or MELD 3.0 \>12 or MELD-Na \>12 or Fibroscan LSM \>20kpa
Patients with chart diagnosis of uncontrolled mental health or schizophrenia

Exclusion

Non-Veteran patients
Patients who do not speak English, do not have access to a telephone or computers, have cognitive impairments, or who are unable to complete a valid informed consent form after three attempts
Patients who have already made significant progress toward our endpoints: a) with prior history of liver transplantation, or b) on the liver transplant waiting list, or c) had formal evaluation for liver transplantation in the past 3 years
Patients with very limited life expectancy (advanced cancer, acute-on-chronic liver failure, and hospice patients)
  • EHR documentation of consideration for liver transplantation change6 and 12 months

    Consideration of Liver Transplantation will be measured dichotomously by assigning a value of 1 if the patient's EHR includes at least one clinician note that documents consideration of liver transplantation as a potential treatment option for the patient within 6 months and 12 months of enrollment, and a value of 0 otherwise.

  • EHR documentation of goals of care conversation change6 and 12 months

    Goals of Care Conversation will be measured dichotomously by assigning a value of 1 if the patient's EHR includes at least one clinician note documenting discussion of goals of care planning within 6 months and 12 months of enrollment, and a value of 0 otherwise.