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BMJ Support Palliat Care doi:10.1136/bmjspcare-2012-000211
  • Feature

Identifying patients with chronic conditions in need of palliative care in the general population: development of the NECPAL tool and preliminary prevalence rates in Catalonia

  1. Carles Constante6
  1. 1The Qualy Observatory/WHO Collaborating Centre for Palliative Care Public Health Programs (WHOCC-ICO), Catalan Institute of Oncology (ICO), Barcelona, Spain
  2. 2Chair of Palliative Care, University of Vic (Barcelona), Barcelona, Spain
  3. 3Programme for the Prevention and Care of Persons with Chronic Conditions, Department of Health, Government of Catalonia, Barcelona, Spain
  4. 4Hospital de la Santa Creu and Hospital General Vic, Barcelona, Spain
  5. 5CAP Remei, Vic-Sud, Equip Atenció Primària, Barcelona, Spain
  6. 6Catalan Department of Health, Government of Catalonia, Barcelona, Spain
  1. Correspondence to Dr Xavier Gómez-Batiste, WHO Collaborating Center for Palliative Care Public Health Programs, Chair ICO/UVIC of Palliative Care, Institut Català d'Oncologia, Hospital Duràn-Reynals, 08908 Hospitalet de Llobregat, Barcelona 08908, Spain; xgomez.whocc{at}iconcologia.net

Abstract

Palliative care (PC) has focused on patients with cancer within specialist services. However, around 75% of the population in middle-income and high-income countries die of one or more chronic advanced diseases. Early identification of such patients in need of PC becomes crucial. In this feature article we describe the initial steps of the NECPAL (Necesidades Paliativas [Palliative Needs]) Programme. The focus is on development of the NECPAL tool to identify patients in need of PC; preliminary results of the NECPAL prevalence study, which assessed prevalence of advanced chronically ill patients within the population and all socio-health settings of Osona; and initial implementation of the NECPAL Programme in the region. As first measures of the Programme, we present the NECPAL tool. The main differences from the British reference tools on which NECPAL is based are highlighted. The preliminary results of the prevalence study show that 1.45% of the total population and 7.71% of the population aged over 65 are ‘surprise question’ positive, while 1.33% and 7.00%, respectively, are NECPAL positive, and surprise question positive with at least one additional positive parameter. More than 50% suffer from geriatric pluri-pathology conditions or dementia. The pilot phase of the Programme consists of developing sectorised policies to improve PC in three districts of Catalonia. The first steps to design and implement a Programme to improve PC for patients with chronic conditions with a public health and population-based approach are to identify these patients and to assess their prevalence in the healthcare system.

  • Received 7 February 2012.
  • Revision received 5 November 2012.
  • Accepted 19 November 2012.
  • Published Online First 14 December 2012

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