Article Text
Abstract
Background Primary care professionals have a major role to play in access towards palliative care. Our hypothesis is that interprofessional teamwork within Multiprofessional Primary Health Care Centres (MPHCs) may contribute to early identification (EI) of patients at the end of life, in order to proceed to the multidimensional assessment (MA) of their needs. EI and MA are not enough and must be combined with an interprofessional training to anticipatory care planning (ACP) in order to increase referral to palliative care services.
Aim To determine if the use of simple identification tools by a primary care team, coupled with an interprofessional training (based on simulation) can improve access to specialist palliative care for patients at the end of life.
Methods Our mixed-methods research includes: a qualitative study in MPHCs and in patients, the development of a simulation-based training, and the evaluation of the whole intervention in a cluster randomised controlled trial.
Results Improvement is expected regarding 1/access to specialist palliative care, 2/respect for the priorities of patients, and 3/unplanned admissions in the last weeks of life.
Discussion Process evaluation will have to consider the influence of different regional contexts or economical models, and the extent of collaboration between primary and secondary care services.
Conclusion Implementing ACP within interprofessional primary care might play a prominent role in accessing palliative care. A well-conducted assessment shall nevertheless precede any wider dissemination.