Impact of Interprofessional Training and Co-ordination on Early Identification and Proactive Approach to End-of-life Situations in the Context of Primary Care

Recruiting

• Conditions: End-of-life Situations; Interprofessional Relations
• Interventions: Other: Patients approaching the end of their lives

• Registration Number: NCT03171779
• Lead Sponsor: Centre Hospitalier Universitaire, Amiens

Brief Summary

More than 300,000 people die each year in France from a disease that may require palliative care. Nevertheless, only a small proportion of these patients are able to access this care, in particular because of a too late identification.

While several factors may hinder access to specialized palliative care resources, one of the major barriers to the initiation of palliative care, and particularly to the implementation of quality end-of-life care, Remains the failure to recognize that patients with advanced chronic illness are actually approaching the end of their lives.

However, it is now clearly established that early integration of palliative care in the care of people living with a serious, incurable and progressive disease:

* has an impact on the quality (and sometimes the expectation) of life of these people,

* avoids aggressive treatments and unplanned hospitalizations,

* is associated with lower health costs than other end-of-life patients. Primary health care providers have a major role to play in facilitating access to palliative care, but their practice has been hampered in our country by the fragmented and poorly coordinated nature of primary care and Negligible in terms of training. However, they remain the first contact of the patients with the system of care, and are also structuring for the continuation of the patient's journey within the health system.

The first hypothesis is that the work of genuine interprofessional primary care teams in multi-professional health centers (MSPs), coupled with adequate training in the use of simple tools, can contribute to the early identification of patients approaching End of life, to meet their palliative care needs.

However, various European programs (Gold Standards Framework in the UK, NECPAL in Catalonia, RADPAC in the Netherlands) have shown that identification alone is not enough to increase access to specialized palliative care. The second hypothesis is that it must be articulated for this with a training of the professionals to carry out conversations of anticipated planning of the care with their patients.

Detailed Description

Not available

Study Timeline

• Study Start: 2015-06-17
• Study First Submitted: 2017-05-29
• Study First Submitted QC: 2017-05-29
• Study First Posted: 2017-05-31
• Status Verified: 2025-03
• Last Update Submitted: 2025-03-27
• Last Update Posted: 2025-04-02
• Primary Completion: 2027-10-18
• Study Completion: 2027-10-18

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 58

Inclusion Criteria

• Being a multi-professional health care home (MSP)
• At least one specialized palliative care resource available in the MSP territory (USP, EMSP, palliative care network)

Exclusion Criteria

• Health centers, group medical practices, clinics
• Less than 3 general practitioners (GPs) and / or absence of nurses (FDI) within the MSP

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
IPEM and PAS	Patients approaching the end of their lives	Interprofessional Early Identification Training and Multidimensional Assessment (IPEM) of patients' palliative needs, and to the Early Care Planning (SAP)
Usual practice	Patients approaching the end of their lives	-
IPEM	Patients approaching the end of their lives	Interprofessional Training in Early Identification and Multidimensional Evaluation (IPEM) of patients' palliative needs

Primary Outcome Measures

Name	Time	Method
Proportion of patients who have died from a condition that may require palliative care	3 years	Proportion of patients who have died from a condition that may require palliative care

Trial Locations

Locations (1)

CHU Amiens Picardie; 🇫🇷 Amiens, Picardie, France