Evidence map›Paper›PMID 33078644›Full record

ArticleThe European journal of general practice2020

Implementation of Primary Palliative Care in five Belgian regions: A qualitative study on early identification of palliative care needs by general practitioners.

Bert Leysen, Olivier Schmitz, Isabelle Aujoulat, Marlène Karam, Bart Van den Eynden, Johan Wens

Abstract read
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Article in The European journal of general practice, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

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3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Bert LeysenPrimary and Interdisciplinary Care, University of Antwerp Faculty of Medicine and Health Sciences, Wilrijk, Belgium.ORCID https://orcid.org/0000-0001-7051-7601
Olivier SchmitzInstitute of Health & Society (IRSS), Université catholique de Louvain Secteur des sciences de la santé, Bruxelles, Belgium.
Isabelle AujoulatInstitute of Health & Society (IRSS), Université catholique de Louvain Secteur des sciences de la santé, Bruxelles, Belgium.
Marlène KaramInstitute of Health & Society (IRSS), Université catholique de Louvain Secteur des sciences de la santé, Bruxelles, Belgium.
Bart Van den EyndenPrimary and Interdisciplinary Care, University of Antwerp Faculty of Medicine and Health Sciences, Wilrijk, Belgium.
Johan WensPrimary and Interdisciplinary Care, University of Antwerp Faculty of Medicine and Health Sciences, Wilrijk, Belgium.ORCID https://orcid.org/0000-0002-0229-9064

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo deliver optimal palliative care, a Care Pathway for Primary Palliative Care (CPPPC) was developed. This CPPPC was implemented by general practitioners (GPs) in territories of five Belgian palliative care networks (2014-2016). Belgian doctors have much therapeutic freedom, and do not commonly follow guidelines.

objectivesTo assess how palliative care was provided by GPs before the CPPPC and its implementation project were presented publicly.

methodsBetween 2013 and 2015, seven focus groups with GPs were conducted. Participants included 15 GPs in three French-speaking focus groups and 26 GPs in four Dutch-speaking focus groups, with diversity for age, gender, palliative care experience and practice context. Some GPs implemented the CPPPC later.

resultsGPs considered each palliative care case unique and disliked strict protocols. However, they expressed a need for peer review and reflective frameworks. GPs felt it is important to identify palliative care patients 'timely', but found this difficult. Screening methods help, but are not widely used. GPs struggled most with identifying palliative care needs in non-oncological patients. Bad news breaking was considered difficult. Continuity of care was considered very important. However, advance care planning seemed more widely practised by Dutch-speaking GPs than by French-speaking GPs. The taboo of palliative care provoked emotional discussions.

conclusionPalliative care frameworks which help GPs to deliver 'tailor-made' care have more chance to be adopted than strict protocols. GPs should be given education for bad news breaking. Palliative care and advance care planning practices differ locally: guideline dissemination plans should respect these local differences.

Indexed as

General PractitionersHealth Services Needs and DemandPalliative CarePrimary Health CareAdultAgedBelgiumContinuity of Patient CareFemaleFocus GroupsHumansMaleMiddle AgedQualitative Researchgeneralgeneral practice/family medicinehealth care organisation and managementPalliative and terminal carequalitative designs and methods

Identifiers

PMID33078644
PMCPMC7592891

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.