Identifying needs and improving palliative care of chronically ill patients

Gómez-Batiste, Xavier; Martínez-Muñoz, Marisa; Blay, Carles; Espinosa, José; Contel, Joan Carles; Ledesma, Albert

doi:10.1097/spc.0b013e328356aaed

Cited by 107 publications

(79 citation statements)

References 45 publications

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“…Therefore, we estimated that 0.75% of a population will have palliative care needs at any one time, and this was used as a benchmark throughout the data analysis. This figure is in accordance with Murtagh et al ,16 Gómez-Batiste et al 17 and Marie Curie's End of Life Care Atlas (from 2011–2012 data) 18…”

Section: Methodssupporting

confidence: 90%

Commissioning of specialist palliative care services in England

Lancaster

Finlay

Downman

et al. 2017

BMJ Support Palliat Care

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Objectives Some failures in end-of-life care have been attributed to inconsistent provision of palliative care across England. We aimed to explore the variation in commissioning of services by Clinical Commissioning Groups (CCGs) using a data collection exercise. Methods We sent a Freedom of Information request in the form of an open questionnaire to all 209 CCGs in England to assess their commissioning of palliative and end-of-life care services, mainly focused on the provision of specialist palliative care services.

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Section: Methodssupporting

confidence: 90%

Commissioning of specialist palliative care services in England

Lancaster

Finlay

Downman

et al. 2017

BMJ Support Palliat Care

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“…One of the aspects for improvement that was identified consisted of extending early PC provision for non-cancer patients into conventional services in all settings of the HCS. The NECPAL (from Necesidades Paliativas in Spanish [Palliative Needs]) Programme is addressing this challenge as a PC public health programme 21 5…”

Section: Introductionmentioning

confidence: 99%

Identifying patients with chronic conditions in need of palliative care in the general population: development of the NECPAL tool and preliminary prevalence rates in Catalonia

Gómez-Batiste

Martínez-Muñoz

Blay

et al. 2012

BMJ Support Palliat Care

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Palliative care (PC) has focused on patients with cancer within specialist services. However, around 75% of the population in middle-income and high-income countries die of one or more chronic advanced diseases. Early identification of such patients in need of PC becomes crucial. In this feature article we describe the initial steps of the NECPAL (Necesidades Paliativas [Palliative Needs]) Programme. The focus is on development of the NECPAL tool to identify patients in need of PC; preliminary results of the NECPAL prevalence study, which assessed prevalence of advanced chronically ill patients within the population and all socio-health settings of Osona; and initial implementation of the NECPAL Programme in the region. As first measures of the Programme, we present the NECPAL tool. The main differences from the British reference tools on which NECPAL is based are highlighted. The preliminary results of the prevalence study show that 1.45% of the total population and 7.71% of the population aged over 65 are 'surprise question' positive, while 1.33% and 7.00%, respectively, are NECPAL positive, and surprise question positive with at least one additional positive parameter. More than 50% suffer from geriatric pluri-pathology conditions or dementia. The pilot phase of the Programme consists of developing sectorised policies to improve PC in three districts of Catalonia. The first steps to design and implement a Programme to improve PC for patients with chronic conditions with a public health and population-based approach are to identify these patients and to assess their prevalence in the healthcare system.

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“…From a research perspective, identifying patients likely to have unmet palliative needs (regardless of where they are perceived to be in their disease trajectory) and evaluating those needs seems a worthy next step. Several approaches to this issue have been developed in Europe, 51,52 but none in the United States using our coding systems.…”

Section: Discussionmentioning

confidence: 99%

Perspectives of Primary Care Providers Toward Palliative Care for Their Patients

Nowels

Jones

Nowels

et al. 2016

The Journal of the American Board of Family Medicine

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Purpose:The need for all providers to deliver basic palliative care has emerged as patients' needs outstrip the capacity of specialty palliative care. Many patients with complex illnesses have unmet needs and are seen in primary care more than other settings. We explore primary care providers' willingness and perceived capacity to provide basic palliative care, and their concerns and perceived barriers.Methods: We performed semistructured telephone interviews with 20 primary care providers about their perceptions of palliative care, including needs, practices, experiences, access, and what would be helpful for their practices to systematically provide basic palliative care.Results: We identified 3 major themes: (1) Participants recognize palliative needs in patients with complex problems. (2) They reactively respond to those needs using practice and community resources, believing that meeting those needs at a basic level is within the scope of primary care. (3) They can identify opportunities to improve the delivery of a basic palliative approach in primary care through practice change and redesign strategies used in enhanced primary care environments.Conclusions: Systematic attention along the multidimensional domains of basic palliative care might allow practices to address unmet needs in patients with complex illnesses by using existing practice improvement models, strategies, and prioritization. (J Am Board Fam Med 2016;29:748 -758.)

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Identifying needs and improving palliative care of chronically ill patients

Cited by 107 publications

References 45 publications

Commissioning of specialist palliative care services in England

Commissioning of specialist palliative care services in England

Identifying patients with chronic conditions in need of palliative care in the general population: development of the NECPAL tool and preliminary prevalence rates in Catalonia

Perspectives of Primary Care Providers Toward Palliative Care for Their Patients

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