-
Palliative medicine · Sep 2024
Feasibility and effectiveness of a two-tiered intervention involving training and a new consultation model for patients with palliative care needs in primary care: A before-after study.
- 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 Prazere... more
- 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.
Notes
Knowledge, pearl, summary or comment to share?