Navigating Difficult Conversations: Discussing Prognosis and Lifelong Care in PBC

August 2025

In this engaging episode, nurse practitioners HoChong Gilles from the Central Virginia VA Healthcare System and Ann Moore from Arizona Liver Health share their expertise on navigating challenging conversations in the care of patients with Primary Biliary Cholangitis (PBC). They explore some of the most difficult topics to address—including disease chronicity, symptom management for fatigue and pruritus, and discussing prognosis—while offering practical communication strategies to build trust, encourage adherence, and provide hope. The conversation covers techniques like motivational interviewing, teach-back methods, and integrating educational resources with psychosocial support. HoChong and Ann highlight the importance of multidisciplinary collaboration, peer support networks, and advocacy groups in enhancing patient understanding and engagement. Whether managing asymptomatic patients, addressing treatment fatigue, or guiding those at risk for disease progression, this discussion delivers valuable, real-world insights for clinicians dedicated to improving quality of life and long-term outcomes in PBC care.