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

Interprofessional Relations Clinical Trial

— SCOP3 quali  

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

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03171779
• Other study ID #: PI2015_843_0038
• Status: Completed
• Start date: June 17, 2015
• Est. completion date: October 18, 2017

Study information

• Verified date: July 2020
• Source: Centre Hospitalier Universitaire, Amiens
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial 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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 1175
• Est. completion date: October 18, 2017
• Est. primary completion date: October 18, 2017
• Accepts healthy volunteers: No
• Gender: All
• Age group: N/A and older

Eligibility

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

Related Conditions & MeSH terms

• End-of-life Situations
• Interprofessional Relations

Intervention

Other:
• Patients approaching the end of their lives
To determine whether the use of simple tools by a primary care team for the early identification of end-of-life patients can improve access to specialized palliative care resources

Locations

Country	Name	City	State
France	CHU Amiens Picardie	Amiens	Picardie

Sponsors (1)

Lead Sponsor	Collaborator
Centre Hospitalier Universitaire, Amiens

Country where clinical trial is conducted

France, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Proportion of patients who have died from a condition that may require palliative care	Proportion of patients who have died from a condition that may require palliative care	3 years