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P-37 Effects of patz groups in primary care; a pilot study
  1. Bregje D Onwuteaka-Philipsen and
  2. HRW Pasman
  1. Department of Public and Occupational Health, EMGO Institute for Health and Care Research, Expertise Center of Palliative Care, VU University Medical Center, Amsterdam, The Netherlands

Abstract

Background In PaTz-groups general practitioners (GPs) and community nurses have regular meetings aiming at improving palliative care. A central aim is to timely identify patients who are in the last phase of life using a register.

Aim Get insight in effects of PaTz-groups on timely identification, the GP knowing the preferred place of death, and number of hospitalizations in the last phase of life.

Methods GPs participating in the first 4 pilot PaTz-groups received pre-structured questionnaires before and 14 months after the start (pretest n = 31 (89%), posttest n = 25 (81%)). They provided information on the most recent deceased patients (excluding sudden deaths) that were under their care (pretest n = 108, post-test n = 90).

Results After implementation of PaTz,identification of patients who might die more often occurred earlier. This was only significant for cancer patients, where the percentage of patients for whom the GP realised more than 3 months before death that the patient would probably die within 6 months from 65% to 78% (p = 0.033). While before PaTz the GP knew the preferred place of death of patients in 79% of patients, this was the case for 88% afterwards (p = 0.066). While before implementation of PaTz 51% of patients was hospitalised once or more in the last month of life, this decreased to 33% after implementation of PaTz (p = 0.022).

Conclusion The results of this pilot study suggest that implementation of PaTz-groups in primary care can be succesful in improving advance care planning resulting in improved care such as reducing hospitalizations at the end of life.

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