Background Most patients with advanced cancer, COPD or CHF live at home. GPs asked for guidance in how to recognise patients in need of palliative care timely and to structure advance care planning (ACP).
Aim We developed a training for GPs in identifying patients in need of palliative care and in structuring ACP and studied its effect on out-of-hours contacts, contacts with their own GP, hospitalizations and place of death.
Methods A cluster RCT. GPs in the intervention condition were trained in identifying patients in need of palliative care and ACP.
After one year, characteristics of patients deceased of cancer, COPD or CHF in both study groups were compared with mixed effects models. As a post-hoc analysis, of identified patients these figures were compared to all other deceased patients.
Results We found no differences between the intervention and control condition. Yet, identified patients had more contacts with their GP (p < 0.0006), were less often hospitalised (p 0.0437) more often died at home (p 0.0572) and less often died in the hospital (p 0.0449) than those not identified.
Discussion Although we did not find differences between the intervention and control condition, 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.
Conclusion Our identification and ACP training seems promising. We recommend future studies that try to further increase identification of patients eligible for ACP.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.