Survey of Italian General Practitioners: Knowledge, Opinions, and Activities of Palliative Care

Beccaro, Monica; Aprile, Pierangelo Lora; Scaccabarozzi, Gianlorenzo; Cancian, Maurizio; Costantini, Massimo

doi:10.1016/j.jpainsymman.2012.08.020

Cited by 28 publications

(48 citation statements)

References 15 publications

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“…In Italy, GPs have a strong importance in the overall management of patients and their families and their judgement can be driven towards decision of care that patients often prefer to share with them rather than with specialists. 15 In such decisions, the generalist often has the last word. For this reason, while conducting research on the appropriate trigger for implementation of PC, the evaluation of their prognostic ability is of great importance.…”

Section: Discussionmentioning

confidence: 99%

The ‘surprise’ question in advanced cancer patients: A prospective study among general practitioners

Bolognesi²,

et al. 2014

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Section: Discussionmentioning

confidence: 99%

The ‘surprise’ question in advanced cancer patients: A prospective study among general practitioners

Bolognesi²,

et al. 2014

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“…In the Netherlands and Belgium GPs are seen as the main care providers for people requiring palliative care [39], [40] and in Spain they are core providers of palliative care in the community [41]. However, there is uncertainty about the role of GPs within specialist palliative care teams in Italy, perhaps due to the heterogeneity of organizational models in the country [42].…”

Section: Methodsmentioning

confidence: 99%

Palliative Care Service Use in Four European Countries: A Cross-National Retrospective Study via Representative Networks of General Practitioners

et al. 2013

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BackgroundDue to a rising number of deaths from cancer and other chronic diseases a growing number of people experience complex symptoms and require palliative care towards the end of life. However, population-based data on the number of people receiving palliative care in Europe are scarce. The objective of this study is to examine, in four European countries, the number of people receiving palliative care in the last three months of life and the factors associated with receiving palliative care.MethodsCross-national retrospective study. Over two years (2009–2010), GPs belonging to representative epidemiological surveillance networks in Belgium, the Netherlands, Italy, and Spain registered weekly all deaths of patients (≥18 years) in their practices and the care they received in the last three months of life using a standardized form. Sudden deaths were excluded.ResultsWe studied 4,466 deaths. GPs perceived to have delivered palliative care to 50% of patients in Belgium, 55% in Italy, 62% in the Netherlands, and 65% in Spain (p<.001). Palliative care specialists attended to 29% of patients in the Netherlands, 39% in Italy, 45% in Spain, and 47% in Belgium (p<.001). Specialist palliative care lasted a median (inter-quartile range) of 15 (23) days in Belgium to 30 (70) days in Italy (p<.001). Cancer patients were more likely than non-cancer patients to receive palliative care in all countries as were younger patients in Italy and Spain with regard to specialist palliative care.ConclusionsAlthough palliative care is established in the countries studied, there are considerable differences in its provision. Two potentially underserved groups emerge non-cancer patients in all countries and older people in Italy and Spain. Future research should examine how differences in palliative care use relate to both patient characteristics and existing national health care policies.

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“…222 Issues related to organisation of care are prominent, if potentially modifi able, barriers to palliative-care provision by PCPs. Patients might lose contact with their PCPs after they are diagnosed with cancer, 223 which makes reinvolvement of PCPs diffi cult at the end-of-life care of a patient with whom they have had little recent contact. This issue might be compounded by poor communication between specialists and PCPs.…”

Section: Barriers To Primary Palliative Carementioning

confidence: 99%

The expanding role of primary care in cancer control

Rubin

Berendsen

Crawford

et al. 2015

The Lancet Oncology

437

450

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The nature of cancer control is changing, with an increasing emphasis, fuelled by public and political demand, on prevention, early diagnosis, and patient experience during and after treatment. At the same time, primary care is increasingly promoted, by governments and health funders worldwide, as the preferred setting for most health care for reasons of increasing need, to stabilise health-care costs, and to accommodate patient preference for care close to home. It is timely, then, to consider how this expanding role for primary care can work for cancer control, which has long been dominated by highly technical interventions centred on treatment, and in which the contribution of primary care has been largely perceived as marginal. In this Commission, expert opinion from primary care and public health professionals with academic and clinical cancer expertise-from epidemiologists, psychologists, policy makers, and cancer specialists-has contributed to a detailed consideration of the evidence for cancer control provided in primary care and community care settings. Ranging from primary prevention to end-of-life care, the scope for new models of care is explored, and the actions needed to eff ect change are outlined. The strengths of primary care-its continuous, coordinated, and comprehensive care for individuals and families-are particularly evident in prevention and diagnosis, in shared follow-up and survivorship care, and in end-of-life care. A strong theme of integration of care runs throughout, and its elements (clinical, vertical, and functional) and the tools needed for integrated working are described in detail. All of this change, as it evolves, will need to be underpinned by new research and by continuing and shared multiprofessional development.

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Survey of Italian General Practitioners: Knowledge, Opinions, and Activities of Palliative Care

Cited by 28 publications

References 15 publications

The ‘surprise’ question in advanced cancer patients: A prospective study among general practitioners

The ‘surprise’ question in advanced cancer patients: A prospective study among general practitioners

Palliative Care Service Use in Four European Countries: A Cross-National Retrospective Study via Representative Networks of General Practitioners

The expanding role of primary care in cancer control

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