title: Effectiveness of the palliative care 'Availability, Current issues and Anticipation' (ACA) communication training programme for general practitioners on patient outcomes: a controlled trial.
abstract: BACKGROUND
  Although communicating effectively with patients receiving palliative care can be difficult, it may contribute to maintaining or enhancing patients' quality of life. Little is known about the effect of training general practitioners in palliative care-specific communication. We hypothesized that palliative care patients of general practitioners exposed to the 'Availability, Current issues and Anticipation' communication training programme would report better outcomes than patients of control general practitioners.
  
  
  OBJECTIVE
  To evaluate the effectiveness of the Availability, Current issues and Anticipation training programme for general practitioners on patient-reported outcomes.
  
  
  METHODS
  In a controlled trial, general practitioners followed the Availability, Current issues and Anticipation programme or were part of the control group. Patients receiving palliative care of participating general practitioners completed the Palliative Care Outcome Scale, the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative, the Rest & Peace Scale, the Patient Satisfaction Questionnaire-III and the Availability, Current issues and Anticipation Scale, at baseline and 12 months follow-up. We analysed differences between groups using linear mixed models.
  
  
  BACKGROUND
  ISRCTN56722368.
  
  
  METHODS
  General practitioners who attended a 2-year Palliative Care Training Course in the Netherlands.
  
  
  RESULTS
  Questionnaire data were available for 145 patients (89 in intervention and 56 in control group). We found no significant differences over time between the intervention and control groups in any of the five outcome measures. Ceiling effects were observed for the Rest & Peace Scale, Patient Satisfaction Questionnaire-III and Availability, Current issues and Anticipation Scale.
  
  
  CONCLUSIONS
  General practitioner participation in the Availability, Current issues and Anticipation training programme did not have a measurable effect on any of the outcomes investigated. Patients reported high levels of satisfaction with general practitioner care, regardless of group assignment. Future research might focus on general practitioners without special interest in palliative care.
authors.affiliation: Department of General Practice and Elderly Care Medicine, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands slortentan@planet.nl w.slort@vumc.nl.
authors.forename: Willemjan
authors.initials: W
authors.lastname: Slort
authors.affiliation: Department of General Practice and Elderly Care Medicine, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Annette H
authors.initials: AH
authors.lastname: Blankenstein
authors.affiliation: Department of General Practice and Elderly Care Medicine, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Bart P M
authors.initials: BP
authors.lastname: Schweitzer
authors.affiliation: Department of Epidemiology and Biostatistics, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Dirk L
authors.initials: DL
authors.lastname: Knol
authors.affiliation: Department of General Practice and Elderly Care Medicine, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Henriëtte E
authors.initials: HE
authors.lastname: van der Horst
authors.affiliation: Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: Neil K
authors.initials: NK
authors.lastname: Aaronson
authors.affiliation: Department of Public and Occupational Health, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands End-of-Life Care Research Group, Vrije Universiteit Brussel & Ghent University, Brussels, Belgium.
authors.forename: Luc
authors.initials: L
authors.lastname: Deliens
mesh_terms: D002983:Clinical Competence; D003142:Communication; D035061:Control Groups; D005194:Family Practice / Q000193:education* / Q000592:standards; D005260:Female; D058005:General Practitioners / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009426:Netherlands; D010166:Palliative Care / Q000379:methods* / Q000523:psychology / Q000592:standards; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D015397:Program Evaluation
keywords: Communication; controlled clinical trial; education medical continuing; family practice; outcome assessment; outcome measurement; palliative care