ArticleBMC family practice2018
Development, modelling, and pilot testing of a complex intervention to support end-of-life care provided by Danish general practitioners.
Article in BMC family practice, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02050256 (Improving End-of-life Care by Continuing Medical Education and Electronic Decision Making Support for General Practitioners in Denmark - an Intervention Study), which is not on this map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Improving End-of-life Care by Continuing Medical Education and Electronic Decision Making Support for General Practitioners in Denmark - an Intervention Study
Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Increasing the chance of dying at home: roles, tasks and approaches of general practitioners enabling palliative care: a systematic review of qualitative literature.BMC primary care · 2023Pooled it
- Evaluation of the Acute Basic Palliation Concept by Relatives and Health Care Professionals: An Observational Study of 40 Home-Dying Patients in Denmark.Palliative medicine reports · 2025Article
- Digital solutions for decision support in general practice - a rapid review focused on systems developed for the universal healthcare setting in Denmark.BMC primary care · 2023Review
- Clinical Decision Support and Implications for the Clinician Burnout Crisis.Yearbook of medical informatics · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMost patients in end-of-life with life-threatening diseases prefer to be cared for and die at home. Nevertheless, the majority die in hospitals. GPs have a pivotal role in providing end-of-life care at patients' home, and their involvement in the palliative trajectory enhances the patient's possibility to stay at home. The aim of this study was to develop and pilot-test an intervention consisting of continuing medical education (CME) and electronic decision support (EDS) to support end-of-life care in general practice.
methodsWe developed an intervention in line with the first phases of the guidelines for complex interventions drawn up by the Medical Research Council. Phase 1 involved the development of the intervention including identification of key barriers to provision of end-of-life care for GPs and of facilitators of change. Furthermore the actual modelling of two components: CME meeting and EDS. Phase 2 focused on pilot-testing and intervention assessment by process evaluation.
resultsIn phase 1 lack of identification of patients at the end of life and limited palliative knowledge among GPs were identified as barriers. The CME meeting and the EDS were developed. The CME meeting was a four-hour educational meeting performed by GPs and specialists in palliative care. The EDS consisted of two parts: a pop-up window for each patient with palliative needs and a list of all patients with palliative needs in the practice. The pilot testing in phase 2 showed that the CME meeting was performed as intended and 120 (14%) of the GPs in the region attended. The EDS was integrated in existing electronic records but was shut down early for external reasons; 50 (5%) GPs signed up. The pilot-testing demonstrated a need to strengthen the implementation as attending rate was low in the current set-up.
conclusionWe developed a complex intervention to support GPs in providing end-of-life care. The pilot-test showed general acceptance of the CME meetings. The EDS was shut down early and needs further evaluation before examining the whole intervention in a larger study, where evaluation could be based on patient-related outcomes and impact on end-of-life care.
trial registrationClinicaltrials.gov ( NCT02050256 ) January 30, 2014.
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