Evidence map›Paper›PMID 34193128›Full record

Observational studyBMC health services research2021

Shifting palliative care paradigm in primary care from better death to better end-of-life: a Swiss pilot study.

Johanna Sommer, Christopher Chung, Dagmar M Haller, Sophie Pautex

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 27% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Article
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

4 authors at 2 institutions in 1 country.

Johanna SommerFaculty of Medicine Geneva, University Institute of Primary Care, University of Geneva, Centre Médical Universitaire, Rue Michel-Servet 1, 1211, Genève 4, Switzerland. Johanna.sommer@unige.ch.
Christopher ChungFaculty of Medicine Geneva, University Institute of Primary Care, University of Geneva, Centre Médical Universitaire, Rue Michel-Servet 1, 1211, Genève 4, Switzerland.
Dagmar M HallerFaculty of Medicine Geneva, University Institute of Primary Care, University of Geneva, Centre Médical Universitaire, Rue Michel-Servet 1, 1211, Genève 4, Switzerland.
Sophie PautexUniversity Hospital of Geneva, Geneva, Switzerland.
University of Geneva · CHUniversity Hospital of Geneva · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients suffering from advanced cancer often loose contact with their primary care physician (PCP) during oncologic treatment and palliative care is introduced very late. The aim of this pilot study was to test the feasibility and procedures for a randomized trial of an intervention to teach PCPs a palliative care approach and communication skills to improve advanced cancer patients' quality of life.

methodsObservational pilot study in 5 steps. 1) Recruitment of PCPs. 2) Intervention: training on palliative care competencies and communication skills addressing end-of-life issues. 3) Recruitment of advanced cancer patients by PCPs. 4) Patients follow-up by PCPs, and assessment of their quality of life by a research assistant 5) Feedback from PCPs using a semi-structured focus group and three individual interviews with qualitative deductive theme analysis.

resultsEight PCPs were trained. Patient recruitment was a challenge for PCPs who feared to impose additional loads on their patients. PCPs became more conscious of their role and responsibility during oncologic treatments and felt empowered to take a more active role picking up patient's cues and addressing advance directives. They developed interprofessional collaborations for advance care planning. Overall, they discovered the role to help patients to make decisions for a better end-of-life.

conclusionsWhile the intervention was acceptable to PCPs, recruitment was a challenge and a follow up trial was not deemed feasible using the current design but PCPs reported a change in paradigm about palliative care. They moved from a focus on helping patients to die better, to a new role helping patients to define the conditions for a better end-of-life.

trial registrationThe ethics committee of the canton of Geneva approved the study (2018-00077 Pilot Study) in accordance with the Declaration of Helsinki.

Indexed as

Palliative CareQuality of LifeDeathHumansPilot ProjectsPrimary Health CareSwitzerlandCancer care / oncologyDeath and dyingDoctor-patient relationshipPalliative care / end-of-lifePrimary careQuality of life

Identifiers

PMID34193128
PMCPMC8245274
OpenAlexW3127614051

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.