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Underutilisation of EPaCCS (Electronic Palliative Care Coordination Systems) in end-of life-care: a cross-sectional study
  1. Lucy Pocock1,
  2. Richard Morris2,
  3. Lydia French1 and
  4. Sarah Purdy1
  1. 1 Centre for Academic Primary Care, University of Bristol Medical School, Bristol, UK
  2. 2 Population Health Sciences, University of Bristol Medical School, Bristol, UK
  1. Correspondence to Dr Lucy Pocock, Centre for Academic Primary Care, University of Bristol Medical School, Bristol, UK; Lucy.Pocock{at}bristol.ac.uk

Abstract

Objective To support greater personalisation of end-of-life care, Electronic Palliative Care Coordination Systems (EPaCCS) have been implemented across England. Here, we describe patient factors associated with dying with an EPaCCS record and explore the association between having an EPaCCS record with cause and place of death.

Method This is a cross-sectional study using routinely collected data. Data were extracted from primary care records in 20 of 86 general practices within one Clinical Commissioning Group in England. All deaths (n=1723) recorded between 22 February 2018 and 21 February 2019 were included to determine whether the deceased patient had an EPaCCS record at the time of death, a range of demographic factors, place of death and cause of death.

Results Only 18% of the sample died with an EPaCCS record, and people who died of a non-cancer cause were less likely to have an EPaCCS record than those who died of cancer (OR=0.41; 95% CI 0.31 to 0.55). Adjusting for patient demographic factors and cause of death, having an EPaCCS record was strongly associated with dying in the community (OR=5.10; 95% CI 3.70 to 7.03).

Conclusions A small proportion of this sample died with an EPaCCS record, despite evidence of an association with dying in the community.

  • chronic conditions
  • communication
  • home care
  • service evaluation
  • terminal care

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Footnotes

  • Twitter @drpoco

  • Contributors All authors made a substantial contribution to the concept and design of the work. RM and LP analysed the data. LP wrote and revised the article. SP, RM and LF made a substantial contribution to the interpretation of the data and critically revised the article. All authors have sufficiently participated in the work to take public responsibility for appropriate portions of the content and approve the version for publication.

  • Funding The lead author was funded by the National Institute for Health Research (NIHR) School for Primary Care Research through a GP Career Progression Fellowship. This research also received funding from the Clinical Commissioning Group under study.

  • Competing interests LP was funded by the National Institute for Health Research (NIHR) School for Primary Care Research through a GP Career Progression Fellowship. This research also received funding from the Clinical Commissioning Group under study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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