Identification of Elderly Patients in Need of Palliative Care by Family Physicians

Overview

In the last decades, the number of people living with chronic diseases had increased, mainly due to the aging of the population. Such chronic, progressive, life threatening and burdening diseases, play an important role in this new era of palliative care. Despite the growing scientific and social interest in palliative care, there is still a delay in the identification of patients with palliative care needs. This leads to a late integration in a palliative care network and consequent deprivation of the major advantages of an early and progressive integration. The aim of this study is to evaluate the role of palliative care training and the use of a structured tool, in the identification of the elderly population in need of palliative care by family physicians. And also to conduct a prevalence study to further the knowledge about how many elder people in primary care have the need of a palliative care approach.

Full Title of Study: “Identification of Elderly Patients in Need of Palliative Care by Family Physicians – the Role of Palliative Care Training and the Use of a Standardized Tool (GerPal_ID). A Two-phase Protocol: Randomized Trial and Prevalence Study”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Screening
    • Masking: None (Open Label)
  • Study Primary Completion Date: December 29, 2020

Detailed Description

The study consists of two phases: 1. Randomized trial with General Practitioners (GP) to determine the role of two different training programs and a structured tool in the identification of geriatric patients with palliative care needs. 2. Cross-sectional, analytical study of the prevalence and patterns of geriatric patients with Palliative Care (PC) needs, managed in primary care in Portugal's Center Healthcare Administrative Region.

Interventions

  • Other: Palliative care training
    • Intervention will consist on providing different types of palliative care training to identify the most accurate on improving GPs’ identification of palliative care patients skills

Arms, Groups and Cohorts

  • No Intervention: Control group
    • GPs (fellows and specialists) from Center Healthcare Administrative Region that will be given no intervention
  • Experimental: Identification tool group
    • GPs (fellows and specialists) from Center Healthcare Administrative Region that will receive access to the Identification tool Supportive and Palliative Care Indicators Tool (SPICT-PT) with a brief training on how to use it.
  • Experimental: Standard Palliative Care Training
    • GPs (fellows and specialists) from Center Healthcare Administrative Region that will receive palliative care training according to the Center Healthcare Administrative Region standard model of training.
  • Experimental: Clinical cases based Palliative Care Training
    • GPs (fellows and specialists) from Center Healthcare Administrative Region that will receive palliative care training using a clinical cases based model.

Clinical Trial Outcome Measures

Primary Measures

  • GPs’ rate of identification of patients with palliative care needs
    • Time Frame: 2 weeks
    • Each GP will have to identify, before each intervention, from a set of fictitious clinical cases constructed for this purpose, which patients need palliative care. After each intervention, they will re-evaluate the same clinical cases and will be asked to identify again which patients need palliative care. Each intervention will be measured according to the identification accuracy.
  • Prevalence geriatric patients with palliative care needs
    • Time Frame: 6 months
    • Number (% of patients) of geriatric patients, managed in primary care in Center Healthcare Administrative Region, with palliative care needs.
  • Sociodemographic characteristics of geriatric patients with palliative care needs
    • Time Frame: 6 months
    • Age (in years), sex (male or female), marital status (single, married, divorced, widow, marriage) and job of geriatric patients, managed in primary care in Center Healthcare Administrative Region, with palliative care needs.
  • Clinical characteristics of geriatric patients with palliative care need
    • Time Frame: 6 months
    • Main diseases, main symptoms, number of contacts with GP/year of geriatric patients, managed in primary care in Center Healthcare Administrative Region, with palliative care needs.
  • Complexity of geriatric patients with palliative care need
    • Time Frame: 6 months
    • Complexity of of geriatric patients, managed in primary care in Center Healthcare Administrative Region, with palliative care needs, evaluated using ICD-Pal tool

Participating in This Clinical Trial

Inclusion Criteria

  • GPs (fellows and specialists) from Center Healthcare Administrative Region Exclusion Criteria:

  • Previous palliative care training. – Refuse to participate

Gender Eligibility: All

Minimum Age: N/A

Maximum Age: N/A

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • University of Beira Interior
  • Provider of Information About this Clinical Study
    • Principal Investigator: Carlos Seiça Cardoso, Principal Investigator – University of Beira Interior
  • Overall Official(s)
    • Carlos Seiça Cardoso, MD, Principal Investigator, Faculty of Health Science – University of Beira Interior

References

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