Interprofessional Relations Clinical Trial
Official title:
Impact of Interprofessional Training and Co-ordination on Early Identification and Proactive Approach to End-of-life Situations in the Context of Primary Care
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.
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