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

Not Applicable

Withdrawn

• Conditions: Geriatrics; Primary Health Care; Palliative Care
• Interventions: Other: Palliative care training

• Registration Number: NCT04010136
• Lead Sponsor: University of Beira Interior

Brief Summary

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.

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.

Study Timeline

• Study First Submitted: 2019-06-14
• Study First Submitted QC: 2019-07-02
• Study First Posted: 2019-07-08
• Study Start: 2019-11-01
• Primary Completion: 2020-12-29
• Study Completion: 2021-12-30
• Status Verified: 2022-10
• Last Update Submitted: 2022-10-31
• Last Update Posted: 2022-11-02

Recruitment & Eligibility

• Status: WITHDRAWN
• Sex: All
• Target Recruitment: Not specified

Inclusion Criteria

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

Exclusion Criteria

• Previous palliative care training.
• Refuse to participate

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Identification tool group	Palliative care training	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.
Standard Palliative Care Training	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.
Clinical cases based Palliative Care Training	Palliative care training	GPs (fellows and specialists) from Center Healthcare Administrative Region that will receive palliative care training using a clinical cases based model.

Primary Outcome Measures

Name	Time	Method
Complexity of geriatric patients with palliative care need	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
GPs' rate of identification of patients with palliative care needs	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.
Clinical characteristics of geriatric patients with palliative care need	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.
Prevalence geriatric patients with palliative care needs	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	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.

Trial Locations

Locations (1)

Center Healthcare Administrative Region; 🇵🇹 Coimbra, Portugal