Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2011 Nov 3:12:123.
doi: 10.1186/1471-2296-12-123.

Early identification of and proactive palliative care for patients in general practice, incentive and methods of a randomized controlled trial

Bregje Thoonsen  1 , Marieke Groot, Yvonne Engels, Judith Prins, Stans Verhagen, Cilia Galesloot, Chris van Weel, Kris Vissers
Affiliations
Randomized Controlled Trial

Early identification of and proactive palliative care for patients in general practice, incentive and methods of a randomized controlled trial

Bregje Thoonsen et al. BMC Fam Pract. .

Abstract

Background: According to the Word Health Organization, patients who can benefit from palliative care should be identified earlier to enable proactive palliative care. Up to now, this is not common practice and has hardly been addressed in scientific literature. Still, palliative care is limited to the terminal phase and restricted to patients with cancer. Therefore, we trained general practitioners (GPs) in identifying palliative patients in an earlier phase of their disease trajectory and in delivering structured proactive palliative care. The aim of our study is to determine if this training, in combination with consulting an expert in palliative care regarding each palliative patient's tailored care plan, can improve different aspects of the quality of the remaining life of patients with severe chronic diseases such as chronic obstructive pulmonary disease, congestive heart failure and cancer.

Methods/design: A two-armed randomized controlled trial was performed. As outcome variables we studied: place of death, number of hospital admissions and number of GP out of hours contacts.

Discussion: We expect that this study will increase the number of identified palliative care patients and improve different aspects of quality of palliative care. This is of importance to improve palliative care for patients with COPD, CHF and cancer and their informal caregivers, and to empower the GP. The study protocol is described and possible strengths and weaknesses and possible consequences have been outlined.

Trial registration: The Netherlands National Trial Register: NTR2815.

PubMed Disclaimer

Figures

Figure 1
Figure 1
What is the moment to start palliative care?, a modified figure of Lynn and Adamson[37] .
Figure 2
Figure 2
Study design randomized controlled trial.
See this image and copyright information in PMC

References

    1. World Health Organisation (WHO) 2002. http://www.who.int/cancer/palliative/definition/en/ Ref Type: Internet Communication.
    1. Qaseem A, Snow V, Shekelle P, Casey DE Jr, Cross JT Jr, Owens DK. et al.Evidence-based interventions to improve the palliative care of pain, dyspnea, and depression at the end of life: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2008;148:141–146. - PubMed
    1. Glare P. Clinical predictors of survival in advanced cancer. J Support Oncol. 2005;3:331–339. - PubMed
    1. Glare P, Sinclair CT. Palliative Medicine Review: Prognostication. J Palliat Med. 2008;11:84–103. doi: 10.1089/jpm.2008.9992. - DOI - PubMed
    1. Glare P, Sinclair C, Downing M, Stone P, Maltoni M, Vigano A. Predicting survival in patients with advanced disease. Eur J Cancer. 2008;44:1146–1156. doi: 10.1016/j.ejca.2008.02.030. - DOI - PubMed

Publication types

MeSH terms