RT Journal Article
SR Electronic
T1 BEFORE THE TIPPING POINT: USING A COMPUTER RECORD SEARCH TO AID IDENTIFICATION OF PATIENTS WITH PALLIATIVE CARE NEEDS IN PRIMARY CARE
JF BMJ Supportive & Palliative Care
JO BMJ Support Palliat Care
FD British Medical Journal Publishing Group
SP A13
OP A13
DO 10.1136/bmjspcare-2014-000654.34
VO 4
IS Suppl 1
A1 Bruce Mason
A1 Kirsty Boyd
A1 Christine Campbell
A1 John Steyn
A1 Marilyn Kendall
A1 Peter Murchie
A1 Scott Murray
YR 2014
UL http://spcare.bmj.com/content/4/Suppl_1/A13.1.abstract
AB Background Primary care is involved in the delivery of end-of-life care for approximately 600,000 people per year in the UK. Many patients who might benefit from proactive interventions at this time are not receiving them because they are not being identified as having “palliative” needs. The use of information technology currently in place in general practices provides opportunities to enhance identification of patients with such needs. Aims To develop and test a primary care electronic record search to identify patients with palliative care needs who are not already on a palliative care register. To assess the feasibility of such a search and its acceptability to primary care professionals. Methods A computer record search was developed then tested in a sample of practices in two Scottish health boards. Quantitative and qualitative data was collected to test the appropriateness of the search results and professional attitudes towards the method. Results The search was run in 10 practices with a total patient population of 83,229 and 69 health professionals present. For each practice, the search generated matches equal to 0.75% to 1.6% of the practice patient population. 30–60% of the patients returned by each search were considered to be at risk of dying by at least one GP. GPs struggled to suggest what additional care they could offer and found the term “palliative care” unhelpful. Although GPs found the search to be a useful tool they expressed reluctance to increase the size of their palliative care register. Conclusions The search successfully made GPs aware of patients who have palliative care needs. However GP attitudes towards palliative care meant that they lacked appropriate actions to take. This computer search is potentially useful but only if it can be paired with actions that can be taken without requiring use of the term “palliative care.”