Training general practitioners contributes to the identification of palliative patients and to multidimensional care provision: secondary outcomes of an RCT.
BACKGROUND
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.


BACKGROUND
NTR2815; post results.
Department of Anaesthesiology, Pain and Palliative Medicine, Radboudumc, Nijmegen, The Netherlands.
Bregje
B
Thoonsen
Department of Anaesthesiology, Pain and Palliative Medicine, Radboudumc, Nijmegen, The Netherlands.
Stefanie H M
SHM
Gerritzen
Department of Anaesthesiology, Pain and Palliative Medicine, Radboudumc, Nijmegen, The Netherlands.
Kris C P
KCP
Vissers
Department of Anaesthesiology, Pain and Palliative Medicine, Radboudumc, Nijmegen, The Netherlands.
Stans
S
Verhagen
Department of Primary and Community Care, Radboudumc, Nijmegen, The Netherlands.|Australian Primary Health Care Research Institute, Australian National University, Canberra, Australia.
Chris
C
van Weel
Department of Anaesthesiology, Pain and Palliative Medicine, Radboudumc, Nijmegen, The Netherlands.
Marieke
M
Groot
Department of Anaesthesiology, Pain and Palliative Medicine, Radboudumc, Nijmegen, The Netherlands.
Yvonne
Y
Engels
D000328:Adult; D005260:Female; D058005:General Practitioners / Q000193:education*; D006333:Heart Failure / Q000451:nursing*; D064946:Hospice and Palliative Care Nursing / Q000193:education*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000451:nursing*; D010166:Palliative Care / Q000379:methods*; D010347:Patient Care Planning; D029424:Pulmonary Disease, Chronic Obstructive / Q000451:nursing*; D012017:Referral and Consultation; D011795:Surveys and Questionnaires
General practitioner; anticipatory care; early palliative care; identification; training