PaTz groups for primary palliative care: reinventing cooperation between general practitioners and district nurses in palliative care: an evaluation study combining data from focus groups and a questionnaire

Plas, A.G.M. van der; Hagens, Martijn; Pasman, H. Roeline W.; Schweitzer, B.; Duijsters, Marij

doi:10.1186/1471-2296-15-14

Cited by 27 publications

(33 citation statements)

References 18 publications

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Section: Findings On the Effectiveness Of Ckd Programsmentioning

confidence: 99%

“…As outlined in Table 4 , of the six studies providing quantitative evidence on program effectiveness, four were conducted in New Zealand [ 22 – 25 ] and two in Australia [ 26 , 27 ]. Four of these were uncontrolled prospective cohort designs carried out over one [ 24 , 25 ] or 2 years [ 23 , 27 ]. Of a number of possible publications reporting effectiveness of the Menzies Renal Treatment Program (MRTP), the thesis by Kondalsamy-Chennakesavan [ 26 ] was selected because it was the most relevant and comprehensive, including two comparisons: 1) before and after the MRTP was handed over to the Tiwi Health Board (THB); and 2) outcomes from the MRTP versus the THB-run Continuing Care Trial (CCT).…”

Section: Findings On the Effectiveness Of Ckd Programsmentioning

confidence: 99%

“… BP, no. antihypertensives, eGFR, ACR, HbA1c Walker et al (2013, 2014) [ 24 , 25 ] To test feasibility and effectiveness of a specialist renal nurse-led self-management intervention to slow progression of CKD. 1 year prospective uncontrolled cohort study, conducted 2011–2012.…”

Section: Findings On the Effectiveness Of Ckd Programsmentioning

confidence: 99%

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Effectiveness, cost effectiveness, acceptability and implementation barriers/enablers of chronic kidney disease management programs for Indigenous people in Australia, New Zealand and Canada: a systematic review of mixed evidence

Reilly

Evans

Gomersall

et al. 2016

BMC Health Serv Res

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BackgroundIndigenous peoples in Australia, New Zealand and Canada carry a greater burden of chronic kidney disease (CKD) than the general populations in each country, and this burden is predicted to increase. Given the human and economic cost of dialysis, understanding how to better manage CKD at earlier stages of disease progression is an important priority for practitioners and policy-makers. A systematic review of mixed evidence was undertaken to examine the evidence relating to the effectivness, cost-effectiveness and acceptability of chronic kidney disease management programs designed for Indigenous people, as well as barriers and enablers of implementation of such programs.MethodsPublished and unpublished studies reporting quantitative and qualitative data on health sector-led management programs and models of care explicitly designed to manage, slow progression or otherwise improve the lives of Indigenous people with CKD published between 2000 and 2014 were considered for inclusion. Data on clinical effectiveness, ability to self-manage, quality of life, acceptability, cost and cost-benefit, barriers and enablers of implementation were of interest. Quantitative data was summarized in narrative and tabular form and qualitative data was synthesized using the Joanna Briggs Institute meta-aggregation approach.ResultsTen studies were included. Six studies provided evidence of clinical effectiveness of CKD programs designed for Indigenous people, two provided evidence of cost and cost-effectiveness of a CKD program, and two provided qualitative evidence of barriers and enablers of implementation of effective and/or acceptable CKD management programs. Common features of effective and acceptable programs were integration within existing services, nurse-led care, intensive follow-up, provision of culturally-appropriate education, governance structures supporting community ownership, robust clinical systems supporting communication and a central role for Indigenous Health Workers.ConclusionsGiven the human cost of dialysis and the growing population of people living with CKD, there is an urgent need to draw lessons from the available evidence from this and other sources, including studies in the broader population, to better serve this population with programs that address the barriers to receiving high-quality care and improve quality of life.

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Section: Findings On the Effectiveness Of Ckd Programsmentioning

confidence: 99%

Section: Findings On the Effectiveness Of Ckd Programsmentioning

confidence: 99%

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Effectiveness, cost effectiveness, acceptability and implementation barriers/enablers of chronic kidney disease management programs for Indigenous people in Australia, New Zealand and Canada: a systematic review of mixed evidence

Reilly

Evans

Gomersall

et al. 2016

BMC Health Serv Res

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“…Older people living at home may also have more need for a transfer to a different care setting or to hospital because organising home care 24 hours per day can be difficult, especially at short notice. Initiatives aimed at improving the provision of palliative care in home settings specifically, 25 or in addition to other settings, 26,27 …”

Section: Comparison With Existing Literaturementioning

confidence: 99%

Comparison of end-of-life care for older people living at home and in residential homes: a mortality follow-back study among GPs in the Netherlands

et al. 2015

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BackgroundThe proportion of older people is increasing, therefore their place of residence and place of care at the end of life are becoming increasingly important. AimTo compare aspects of end-of-life care among older people in residential homes and home settings in the Netherlands. Design and settingNationwide representative mortality followback study among GPs in the Netherlands. MethodThe study included patients aged ≥65 years who died non-suddenly, whose longest place of residence in their last year of life was at home or in a residential home (n = 498). Differences were analysed using Pearson's χ 2 test, MannWhitney U tests, and multivariate logistic regression. ResultsControlling for the differences between the populations in home settings and residential homes, no differences were found in treatment goals, communication about end-of-life care, or use of specialised palliative care between the two settings. However, people living in a residential home were more likely to have received palliative care from a GP than people living at home (OR 2.84, 95% confidence interval [CI] = 1.41 to 5.07). In residential homes, people more often experienced no transfer between care settings (OR 2.76, 95% CI = 1.35 to 5.63) and no hospitalisations (OR 2.2, 95% CI = 1.04 to 4.67) in the last 3 months of life, and died in hospital less often (OR 0.78, 95% CI = 0.63 to 0.97) than those people living at home. ConclusionDespite similar treatment goals, care in residential homes seems more successful in avoiding transfers and hospitalisation at the end of life. Especially since older people are encouraged to stay at home longer, measures should be taken to ensure they are not at higher risk of transfers and hospitalisations in this setting. Keywordsend of life care; general practitioner; palliative care; residential facilities; terminal care.

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“…This implies that the general practitioner (GP) should be the coordinator of their care. Several studies report on the tools that have been developed to support the GP in this specific role: an instrument to help GPs stimulate patient-centred communication [ 6 ]; a method to improve interaction between GPs and district nurses [ 7 ]; and a communication training programme for GPs [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Timely identification of palliative patients and anticipatory care planning by GPs: practical application of tools and a training programme

et al. 2016

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BackgroundPalliative care is mainly restricted to terminal care. General practitioners (GPs) are not trained to early identify palliative patients with cancer, COPD or heart failure. With the help of the RADboud indicators for PAlliative Care needs (RADPAC), we trained GPs to identify patients’ needs and to make a proactive care plan. They were also able to join two role-plays where they discussed the patient’s future, and consulted a palliative care consultant to fine-tune the care plan. We evaluated the programme with the GPs and consultants and noted its impact on their daily practice.MethodsTwo years after they had participated in the programme, we held semi-structured interviews with the GPs and a focus group interview with the consultants and performed a thematic content analysis.ResultsSix consultants and nine GPs participated in the programme. Most GPs and consultants mentioned positive changes in the thinking or acting of GPs regarding early palliative care. A number continued to use the tool to identify patients; most of the others noted they had internalised the indicators. Although half of them still considered discussing end-of-life aspects difficult, particularly in patients with organ failure, the others were more easily able to discuss the future with their palliative patients.ConclusionAlthough most GPs and consultants were positive about the training programme and applying it in daily practice, we conclude that in future programmes, more attention needs to paid to timely identification of palliative patients with COPD or CHF and how to discuss the future with them.

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PaTz groups for primary palliative care: reinventing cooperation between general practitioners and district nurses in palliative care: an evaluation study combining data from focus groups and a questionnaire

Cited by 27 publications

References 18 publications

Effectiveness, cost effectiveness, acceptability and implementation barriers/enablers of chronic kidney disease management programs for Indigenous people in Australia, New Zealand and Canada: a systematic review of mixed evidence

Effectiveness, cost effectiveness, acceptability and implementation barriers/enablers of chronic kidney disease management programs for Indigenous people in Australia, New Zealand and Canada: a systematic review of mixed evidence

Comparison of end-of-life care for older people living at home and in residential homes: a mortality follow-back study among GPs in the Netherlands

Timely identification of palliative patients and anticipatory care planning by GPs: practical application of tools and a training programme

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