Can death from chronic life-limiting illnesses be predicted in Australian general practice? A study exploring the feasibility and acceptability of a case finding approach to care planning of patients nearing the end-of-life.

The study of Australian general practitioners using a systematic death prediction tool versus clinical intuition on the accuracy of prediction of patient death.

Status

Active, not recruiting

Phases

Unknown

Study type

Observational

Source

ANZCTR

Registry ID

ACTRN12613000266763

Enrollment

Registered

2013-03-06

Start date

2012-12-05

Completion date

2013-08-16

Last updated

2020-01-13

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

General Practitioners (GP) have a key role to play in the care of dying patients. General practice is defined by the continuity of care and trusting long-term doctor-patient relationships. This means that general practitioners are well placed to provide quality end of life care to patients. This research explores the feasibility and acceptability of a general practice based case-finding approach to care planning of patients nearing the end of life. General practices will be recruited to test the accuracy of GPs clinical acumen in predicting which of their patients will die in the next 6 months. A number of practices will make use of a clinical prediction tool in addition to the GPs clinical acumen to see whether this improves the accuracy of prognostication. The findings of the project will help to determine the best way of identifying patients who are in need of end of life care planning. Our aim is to use the data gathered from this study as a springboard into developing a solid evidence-based intervention that could be used in general practice to identify and plan the care of patients who are nearing the end of life.

Interventions

Systematic clinical prediction tool, (modified version of the SPICT tool developed in the UK), used to help the GP in identifying patients at risk of dying in the next 12 months. The tool comprises of three elements: (i) 'surprise' question, (ii) general indicators of health, (iii) specific indicators around advanced conditions.

Eligibility

Sex/Gender

All

Age

70 Years to No maximum

Healthy volunteers

Inclusion criteria

Inclusion criteria for GPs: 1. Working in active clinical general practice. 2. Working in Sydney or Brisbane. Inclusion criteria for patients: 1. Patients of participating GPs 2. Greater than or equal to 70 years of age or patients under 70 years of age who have been identified as the GP as being at risk of dying in the next 12 months

Exclusion criteria

Exclusion criteria for GPs: 1. Not seeing patients >70 years of age. 2. Not having computerised practice database. 3. Having worked <12 months in the practice. Exclusion criteria for patients: 1. Patients under 70 years of age unless they have been identified by the participating GP as being at risk of dying in the next 12 months.

Outcome results