• Seiça CardosoCarlosC0000-0001-9214-6995Faculty of Medicine, University of Coimbra, Coimbra, Portugal.CINTESIS@RISE, MEDCIDS, Faculty of Medicine of the University of Porto, Porto, Portugal., Filipe Prazeres, Bárbara Oliveiros, Cátia Nunes, Pedro Simões, Carolina Aires, Patrícia Rita, Joana Penetra, Paulo Lopes, Sara Alcobia, Sara Baptista, Carla Venâncio, and Barbara Gomes.
• Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
• Palliat Med. 2024 Sep 1; 38 (8): 842852842-852.

BackgroundEvidence suggests that involving General Practitioners in the care of patients with palliative care needs may improve patient outcomes.AimTo evaluate whether a two-tiered intervention involving training in palliative care and a new consultation model in primary care for patients with palliative care needs is feasible and could reduce patients' symptom burden.DesignBefore-after study including an internal pilot.Setting/ParticipantsNine general practitioners working in a health region in Portugal and 53 patients with palliative care needs from their patient lists were recruited. General Practitioners received training in palliative care and used a new primary palliative care consultation model, with medical consultations every 3 weeks for 12 weeks. The primary outcome was physical symptom burden, self-reported using the Integrated Palliative care Outcome Scale (IPOS) patient version (min.0-max.1000). Secondary outcomes included emotional symptoms (min.0-max.400) and communication/practical issues (min.0-max.300).ResultsOf the 35/53 patients completed the 12-week intervention (mean age 72.53 years, SD = 13.45; 54.7% female). All had advanced disease: one third had cancer (n = 13), one third had congestive heart failure (n = 12); others had chronic kidney disease and chronic obstructive pulmonary disease. After the 12 weeks of intervention, there was a reduction in physical symptom burden [mean difference from baseline of 71.42 (95%CI 37.01-105.85) with a medium-large effect size (0.71], and in emotional symptom burden [mean difference 42.86 (95%CI 16.14-69.58), with a medium effect size (0.55)]. No difference was found for communication/practical issues.ConclusionsOur intervention can be effective in reducing patients' physical and emotional symptoms.Trial RegistrationClinicalTrials.gov ID - NCT05244590. Registration: 14th February 2022.

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