Practical tools for implementing early palliative care in advanced lung cancer

Janssens, Annelies; Teugels, Liesbeth; Kohl, Sisca; Michielsen, Toke; Leysen, Bert; Meerbeeck, Jan P. van

doi:10.1183/13993003.00382-2015

Cited by 6 publications

(3 citation statements)

References 4 publications

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“…In the University Hospital of Area 1, a well-motivated thoracic oncologist initiated a palliative care consultation within 12 weeks after a patient received diagnosis of lung cancer. After this consultation, the patient’s GP was contacted via telephone [25]. During these routine calls to GPs the pro-Spinoza project was also discussed.…”

Section: Resultsmentioning

confidence: 99%

Recruiting general practitioners for palliative care research in primary care: real-life barriers explained

et al. 2019

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Background The implementation of early palliative care within a primary care setting is a recent academic topic. Recruiting General Practitioners (GPs) to participate in a palliative care study can be challenging. The pro-Spinoza project implemented a Care Pathway for Primary Palliative Care in 5 areas in Belgium. During this project, the feasibility of the recruitment of GPs and palliative care patients was evaluated. Methods The recruitment process was recorded in detail via an electronic logbook combining quantitative and qualitative data. Quantitative recordings included the contact types and the number of contacts with eligible GPs and were analysed descriptively. Qualitative recordings included field notes with feedback from the GPs and other stakeholders and were thematically analysed starting from the Grol and Wensing framework for professional behaviour change. Results Of 4065 eligible GPs working in 5 areas under research, 787 GPs (19%) were contacted individually, 398 GPs (9,8%) were contacted face-to-face and most of these 398 GPs showed high interest in the topic. 112 GPs (2,8%) signed the collaboration agreement, but finally only 65 GPs (1,6%) delivered at least a completed baseline-questionnaire. Despite the initial interest in participating, the unpredictable and busy daily workloads of the GPs, as well as inexperience with research protocols, impeded the ability of the GPs to fully engage in the study. This resulted in the high dropout rate. Participating GPs reported that they had underestimated the effort required to effectively participate in the project. Conclusions Recruitment of GPs to palliative care research is challenging. Primary care is a vital service to engage in palliative care research however the practical limitations reduce the ability of the service to effectively engage in the research. More research is needed to determine how GPs might be better supported in research. Trial registration ClinicalTrials.gov, NCT02266069 , Registered 16th October 2014, retrospectively registered.

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Section: Resultsmentioning

confidence: 99%

Recruiting general practitioners for palliative care research in primary care: real-life barriers explained

et al. 2019

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“…There may be other reasons for the high heterogeneity that cannot be translated into specific variables. For example, the interventions studied vary from country to country due to differences in health policies, healthcare systems and healthcare resources, which is difficult to measure on the same scale (Gaertner et al, 2015; Hui et al, 2015; Janssens et al, 2016). Therefore, it is too early to draw definitive conclusions that early palliative care can improve the quality of life of patients with incurable diseases.…”

Section: Discussionmentioning

confidence: 99%

Effects of early palliative care on patients with incurable cancer: A meta‐analysis and systematic review

Huo

Song

Chang

et al. 2022

European J Cancer Care

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Objective This meta‐analysis aims to compare the effects of early palliative care on patients with incurable cancer with those of standard oncologic care or on‐demand palliative care. Methods Pubmed, Embase, Web of Science, Cochrane Library, ClinicalTrials.gov and World Health Organization International Clinical Trials Registry Platform (ICTRP) were searched for relevant randomised controlled trials. We also screened reference lists of included studies for additional qualified studies. We used Cochrane Collaboration Risk of Bias Tool to evaluate quality of included studies. DerSimonian and Laird's random effects meta‐analysis was used to synthesise the effects. Results Sixteen in 1376 studies were included. The pooled data suggested that patients receiving early palliative care had better quality of life (SMD = 0.737, 95% CI: 0.240–1.234), fewer symptoms (SMD = 0.304, 95% CI: 0.097–0.510), better mood (SMD = −0.443, 95% CI: −0.605 to −0.282), better survival (hazard ratio [HR] of death: HR = 1.521, 95% CI: 1.521–1.923; 1‐year overall survival probability: HR = 1.238, 95% CI: 1.031–1.486) and higher probability of dying at home (HR = 1.153, 95% CI: 1.027–1.295) than patients in the control group. And there is no difference between resource use. Conclusion Early palliative care improves lives of patients with incurable cancer, but the evidence level is low because of high heterogeneity of quality of life and small numbers of included studies for other results.

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“…This is one of the reasons why EPC remains challenging although initiatives are taken to fulfill this unmet need. 64…”

Section: Pc and End-of-life Carementioning

confidence: 99%

Lung Cancer in Belgium

Ocak

Tournoy

Berghmans

et al. 2021

Journal of Thoracic Oncology

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The kingdom of Belgium with its capital Brussels is located in Western Europe (Fig. 1) and has a population of 11,492,641 inhabitants (January 2020) for a surface of 30,689 km 2 . The country is a member of the European Union (EU) and federally organized with a Dutchspeaking majority in the northern Flemish region, a French-speaking region (Wallonia) in the south, and the Brussels capital region. Its population is mainly of White, with 10% immigrants from different non-EU countries, mostly Africa and Middle East.The organization of its "Bismarck type" health care is based on principles of therapeutic freedom for physicians, freedom of choice for patients, and fee for service payment. 1 All disease-oriented care is of federal competence, whereas prevention, screening, teaching, and health care organization are of regional competence. Health care is financed through a compulsory social insurance covering almost the whole population and administrated by a National Institute for Health and Disability, representing the following different stakeholders: sickness funds, (para)medical health care workers, pharmaceutical industry, and the federal ministry of Social Affairs, the latter covering theyearly increasing-deficits in annual budget. In 2019, the share of health care spending represented 14.6% of all taxes and contributions and 10.3% of the gross domestic product. 2 It is estimated that an additional 1% is spent on out-of-pocket contributions and ispartially-reimbursed by private insurances, proposed by various sickness funds and private companies.The density of health care resources is high: Belgium has 34,962 "acute care" beds in 128 hospitals, seven of which linked to a university medical faculty. 3 All hospitals were recently grouped in 25 locoregional networks, each covering approximately 500,000 citizens. A National Electronic Health Database (e-Health) for physicians makes institutional medical data available on a single platform and largely facilitates cross-referrals and second opinions. This platform is linked to Social Security's data warehouse, which allows for checking the patient's vital status. The publication of two royal decrees introduced multidisciplinary tumor boards (MDTBs) and oncological care programs in 2002 and 2003, respectively. Because the endorsement of the National Cancer Plan (NCP) of 2008,

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Practical tools for implementing early palliative care in advanced lung cancer

Cited by 6 publications

References 4 publications

Recruiting general practitioners for palliative care research in primary care: real-life barriers explained

Recruiting general practitioners for palliative care research in primary care: real-life barriers explained

Effects of early palliative care on patients with incurable cancer: A meta‐analysis and systematic review

Lung Cancer in Belgium

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