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Training general practitioners contributes to the identification of palliative patients and to multidimensional care provision: secondary outcomes of an RCT
  1. Bregje Thoonsen1,
  2. Stefanie H M Gerritzen1,
  3. Kris C P Vissers1,
  4. Stans Verhagen1,
  5. Chris van Weel2,3,
  6. Marieke Groot1 and
  7. Yvonne Engels1
  1. 1Department of Anaesthesiology, Pain and Palliative Medicine, Radboudumc, Nijmegen, The Netherlands
  2. 2Department of Primary and Community Care, Radboudumc, Nijmegen, The Netherlands
  3. 3Australian Primary Health Care Research Institute, Australian National University, Canberra, Australia
  1. Correspondence to Dr Yvonne Engels, Radboud University Medical Center, Department of Anesthesiology, Pain and Palliative Medicine, Post Box 9101, Internal Post Code 549, Nijmegen 6500 HB, The Netherlands; yvonne.engels{at}radboudumc.nl

Abstract

Introduction To support general practitioners (GPs) in providing early palliative care to patients with cancer, chronic obstructive pulmonary disease or heart failure, the RADboud university medical centre indicators for PAlliative Care needs tool (RADPAC) and a training programme were developed to identify such patients and to facilitate anticipatory palliative care planning. We studied whether GPs, after 1 year of training, identified more palliative patients, and provided multidimensional and multidisciplinary care more often than untrained GPs.

Methods We performed a survey 1 year after GPs in the intervention group of an RCT were trained. With the help of a questionnaire, all 134 GPs were asked how many palliative patients they had identified, and whether anticipatory care was provided. We studied number of identified palliative patients, expected lifetime, contact frequency, whether multidimensional care was provided and which other disciplines were involved.

Results Trained GPs identified more palliative patients than did untrained GPs (median 3 vs 2; p 0.046) and more often provided multidimensional palliative care (p 0.024). In both groups, most identified patients had cancer.

Conclusions RADPAC sensitises GPs in the identification of palliative patients. Trained GPs more often provided multidimensional palliative care. Further adaptation and evaluation of the tools and training are necessary to improve early palliative care for patients with organ failure.

Trial registration number NTR2815; post results.

  • General practitioner
  • early palliative care
  • identification
  • training
  • anticipatory care

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