Training general practitioners in early identification and anticipatory palliative care planning: A randomized controlled trial Clinical presentation, diagnosis, and management
-
Altmetric Citations
Thoonsen, Bregje; Vissers, Kris C.; Verhagen, Stans; Prins, Judith; Bor, Hans; de Groot, Robert A.; Engels, Yvonne; van Weel, Chris
Description
Background: Most patients with advanced cancer, debilitating COPD or chronic heart failure (CHF) live at home. General practitioners (GPs) asked for guidance in how to recognize patients in need of palliative care in a timely way and to structure anticipatory care. For that reason, we developed a training for GPs in identifying patients in need of palliative care and in structuring anticipatory palliative care planning and studied its effect on out-of-hours contacts, contacts with their own GP,...[Show more]
dc.contributor.author | Thoonsen, Bregje | |
---|---|---|
dc.contributor.author | Vissers, Kris C. | |
dc.contributor.author | Verhagen, Stans | |
dc.contributor.author | Prins, Judith | |
dc.contributor.author | Bor, Hans | |
dc.contributor.author | de Groot, Robert A. | |
dc.contributor.author | Engels, Yvonne | |
dc.contributor.author | van Weel, Chris | |
dc.date.accessioned | 2016-02-24T22:41:09Z | |
dc.identifier.issn | 1471-2296 | |
dc.identifier.uri | http://hdl.handle.net/1885/98586 | |
dc.description.abstract | Background: Most patients with advanced cancer, debilitating COPD or chronic heart failure (CHF) live at home. General practitioners (GPs) asked for guidance in how to recognize patients in need of palliative care in a timely way and to structure anticipatory care. For that reason, we developed a training for GPs in identifying patients in need of palliative care and in structuring anticipatory palliative care planning and studied its effect on out-of-hours contacts, contacts with their own GP, hospitalizations and place of death. Methods: We performed a cluster randomised controlled trial. GPs in the intervention group were trained in identifying patients in need of palliative care and anticipatory care planning. Next, for each identified patient, they were offered a coaching session with a specialist in palliative care to fine-tune a structured care plan. The GPs in the control group did not receive training or coaching, and were asked to provide care as usual. After one year, characteristics of patients deceased of cancer, COPD or CHF in both study groups were compared with mixed effects models for out-of-hours contacts (primary outcome), contacts with their own GP, place of death and hospitalizations in the last months of their life (secondary outcomes). As a post-hoc analysis, of identified patients (of the intervention GPs) these figures were compared to all other deceased patients, who had not been identified as in need of palliative care. Results: We did not find any differences between the intervention and control group. Yet, only half of the trained GPs (28) identified patients (52), which was only 24 % of the deceased patients. Those identified patients had significantly more contacts with their own GP (B 4.5218; p <0.0006), were less often hospitalized (OR 0.485; p 0.0437) more often died at home (OR 2.126; p 0.0572) and less often died in the hospital (OR 0.380; p 0.0449). Conclusions: Although we did not find differences between the intervention and control group, we found in a post-hoc analysis that those patients that had been identified as in need of palliative care had more contacts with their GP, less hospitalizations, and more often died at home. We recommend future controlled studies that try to further increase identification of patients eligible for anticipatory palliative care. The Netherlands National Trial Register: NTR2815 date 07-04-2010. | |
dc.publisher | BioMed Central | |
dc.rights | Author/s retain copyright | |
dc.source | BMC Family Practice Journal | |
dc.title | Training general practitioners in early identification and anticipatory palliative care planning: A randomized controlled trial Clinical presentation, diagnosis, and management | |
dc.type | Journal article | |
local.description.notes | Imported from ARIES | |
local.identifier.citationvolume | 16 | |
dc.date.issued | 2015 | |
local.identifier.absfor | 111701 - Aboriginal and Torres Strait Islander Health | |
local.identifier.absfor | 111717 - Primary Health Care | |
local.identifier.absfor | 160104 - Social and Cultural Anthropology | |
local.identifier.ariespublication | U3488905xPUB6127 | |
local.type.status | Published Version | |
local.contributor.affiliation | Thoonsen, Bregje, Radboud University Nijmegen Medical Centre | |
local.contributor.affiliation | Vissers, Kris C., Radboud University Nijmegen Medical Centre | |
local.contributor.affiliation | Verhagen, Stans, Radboud University Nijmegen Medical Centre | |
local.contributor.affiliation | Prins, Judith, Radboud University Nijmegen Medical Centre | |
local.contributor.affiliation | Bor, Hans , Radboud University Nijmegen Medical Center | |
local.contributor.affiliation | Van Weel, Chris, College of Medicine, Biology and Environment, ANU | |
local.contributor.affiliation | de Groot, Robert A., Radboud University Nijmegen | |
local.contributor.affiliation | Engels, Yvonne, Radboud University Nijmegen Medical Centre | |
local.bibliographicCitation.issue | 1 | |
local.bibliographicCitation.startpage | 1 | |
local.bibliographicCitation.lastpage | 12 | |
local.identifier.doi | 10.1186/s12875-015-0342-6 | |
dc.date.updated | 2016-02-24T10:09:53Z | |
local.identifier.scopusID | 2-s2.0-84942500731 | |
dcterms.accessRights | Open Access | |
Collections | ANU Research Publications |
Download
File | Description | Size | Format | Image |
---|---|---|---|---|
01_Thoonsen_Training_general_practitioners_2015.pdf | 664.15 kB | Adobe PDF |
Items in Open Research are protected by copyright, with all rights reserved, unless otherwise indicated.
Updated: 17 November 2022/ Responsible Officer: University Librarian/ Page Contact: Library Systems & Web Coordinator