1. Early identification of and proactive palliative care for patients in general practice, incentive and methods of a randomized controlled trial
- Author
-
Bregje Thoonsen, Chris van Weel, Yvonne Engels, Stans Verhagen, Cilia Galesloot, Kris Vissers, Marieke Groot, and Judith B. Prins
- Subjects
Male ,medicine.medical_specialty ,Palliative care ,Time Factors ,General Practice ,MEDLINE ,Aetiology, screening and detection [ONCOL 5] ,Severity of Illness Index ,law.invention ,Pulmonary Disease, Chronic Obstructive ,Study Protocol ,Quality of life (healthcare) ,Randomized controlled trial ,law ,General Practitioners ,Neoplasms ,Severity of illness ,Medicine ,Humans ,Terminally Ill ,Intensive care medicine ,Curative care ,Netherlands ,Pain Measurement ,Heart Failure ,COPD ,lcsh:R5-920 ,business.industry ,Palliative Care ,Effective primary care and public health [NCEBP 7] ,Middle Aged ,medicine.disease ,Psychological determinants of chronic illness Quality of Care [NCEBP 8] ,Effective primary care and public health Age-related aspects of cancer [NCEBP 7] ,Incentive ,Caregivers ,Quality of Life ,Female ,business ,lcsh:Medicine (General) ,Family Practice - Abstract
Background According to the Word Health Organization, patients who can benefit from palliative care should be identified earlier to enable proactive palliative care. Up to now, this is not common practice and has hardly been addressed in scientific literature. Still, palliative care is limited to the terminal phase and restricted to patients with cancer. Therefore, we trained general practitioners (GPs) in identifying palliative patients in an earlier phase of their disease trajectory and in delivering structured proactive palliative care. The aim of our study is to determine if this training, in combination with consulting an expert in palliative care regarding each palliative patient's tailored care plan, can improve different aspects of the quality of the remaining life of patients with severe chronic diseases such as chronic obstructive pulmonary disease, congestive heart failure and cancer. Methods/Design A two-armed randomized controlled trial was performed. As outcome variables we studied: place of death, number of hospital admissions and number of GP out of hours contacts. Discussion We expect that this study will increase the number of identified palliative care patients and improve different aspects of quality of palliative care. This is of importance to improve palliative care for patients with COPD, CHF and cancer and their informal caregivers, and to empower the GP. The study protocol is described and possible strengths and weaknesses and possible consequences have been outlined. Trial Registration The Netherlands National Trial Register: NTR2815
- Full Text
- View/download PDF