Evidence map›Paper›PMID 38783755›Full record

Trial reportAge and ageing2024

Evaluating palliative care case conferences in primary care for patients with advanced non-malignant chronic conditions: a cluster-randomised controlled trial (KOPAL).

Tina Mallon, Josefine Schulze, Judith Dams, Jan Weber, Thomas Asendorf, Silke Böttcher, Uta Sekanina, Franziska Schade, Nils Schneider, Michael Freitag and 6 more

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in Age and ageing, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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.

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

4 citing papers in PubMed.

  1. Trial
  2. Review
  3. Article
  4. 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

16 authors.

Tina MallonDepartment of General Practice and Primary Care, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.
Josefine SchulzeDepartment of General Practice and Primary Care, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.
Judith DamsDepartment of Health Economics and Health Care Research, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.
Jan WeberInstitute for General Practice and Palliative Care, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.
Thomas AsendorfDepartment of Medical Statistics, University Medical Centre Göttingen, Humboldtallee 32, 37073 Göttingen, Germany.
Silke BöttcherDivision of General Practice, Carl von Ossietzky University of Oldenburg, Ammerlaender Heerstraße 114-118, 26129 Oldenburg, Germany.
Uta SekaninaDepartment of General Practice, University Medical Centre Göttingen, Humboldtallee 38, 37073 Göttingen, Germany.
Franziska SchadeDepartment of Palliative Medicine, University Medical Centre Göttingen, Von-Siebold-Str. 3, 37075 Göttingen and Institute for General Practice and Palliative Care, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
Nils SchneiderInstitute for General Practice and Palliative Care, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.
Michael FreitagDivision of General Practice, Carl von Ossietzky University of Oldenburg, Ammerlaender Heerstraße 114-118, 26129 Oldenburg, Germany.
Christiane MüllerDepartment of General Practice, University Medical Centre Göttingen, Humboldtallee 38, 37073 Göttingen, Germany.
Hans-Helmut KönigDepartment of Health Economics and Health Care Research, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.
Friedemann NauckDepartment of Palliative Medicine, University Medical Centre Göttingen, Von-Siebold-Str. 3, 37075 Göttingen, Germany.
Tim FriedeDepartment of Medical Statistics, University Medical Centre Göttingen, Humboldtallee 32, 37073 Göttingen, Germany.ORCID 0000-0001-5347-7441
Martin SchererDepartment of General Practice and Primary Care, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.
Gabriella MarxDepartment of General Practice and Primary Care, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.

Funding

Innovation Fund of the Federal Joint Committee 01VSF18024
6 · The paper itself

Abstract

backgroundPatients with congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD) and dementia are underrepresented in specialist palliative home care (SPHC). However, the complexity of their conditions requires collaboration between general practitioners (GPs) and SPHC teams and timely integration into SPHC to effectively meet their needs.

objectiveTo facilitate joint palliative care planning and the timely transfer of patients with advanced chronic non-malignant conditions to SPHC.

methodsA two-arm, unblinded, cluster-randomised controlled trial. 49 GP practices in northern Germany were randomised using web-based block randomisation. We included patients with advanced CHF, COPD and/or dementia. The KOPAL intervention consisted of a SPHC nurse-patient consultation followed by an interprofessional telephone case conference between SPHC team and GP. The primary outcome was the number of hospital admissions 48 weeks after baseline. Secondary analyses examined the effects on health-related quality of life and self-rated health status, as measured by the EuroQol 5D scale.

resultsA total of 172 patients were included in the analyses. 80.4% of GP practices had worked with SHPC before, most of them exclusively for cancer patients. At baseline, patients reported a mean EQ-VAS of 48.4, a mean quality of life index (EQ-5D-5L) of 0.63 and an average of 0.80 hospital admissions in the previous year. The intervention did not significantly reduce hospital admissions (incidence rate ratio = 0.79, 95%CI: [0.49, 1.26], P = 0.31) or the number of days spent in hospital (incidence rate ratio = 0.65, 95%CI: [0.28, 1.49], P = 0.29). There was also no significant effect on quality of life (∆ = -0.02, 95%CI: [-0.09, 0.05], P = 0.53) or self-rated health (∆ = -2.48, 95%CI: [-9.95, 4.99], P = 0.51).

conclusionsThe study did not show the hypothesised effect on hospitalisations and health-related quality of life. Future research should focus on refining this approach, with particular emphasis on optimising the timing of case conferences and implementing discussed changes to treatment plans, to improve collaboration between GPs and SPHC teams.

Indexed as

Heart FailurePalliative CarePrimary Health CarePulmonary Disease, Chronic ObstructiveQuality of LifeAgedAged, 80 and overChronic DiseaseDelivery of Health Care, IntegratedDementiaFemaleGermanyHome Care ServicesHumansInterdisciplinary CommunicationMalecase conferencechronic careinterprofessional communicationolder peoplepalliative careprimary health care

Identifiers

PMID38783755
PMCPMC11116821

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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.