Patients with life-limiting, chronic progressive oncological and non-oncological diseases, being in general practitioners care in the chosen Region.
Conditions
Interventions
Group 1: a. Stakeholder in the targeted health region, experts interviews for
(t=0) Exploration the health region. Infrastructure, care experiences, care situation and cooperation between different a
Sponsors
Medizinische Hochschule Hannover
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: a. General practitioners Located GPs in targeted region, who are registered in the region within the duration of the project (independent by sex) b. Deceased patients of targeted GPs practice Deceased as a result of life-limiting, chronic progressive oncological and non-oncological diseases within period of observation and while in GPs care, age > 18 (independent of sex) c. Remained relatives of deceased patients in GPs practice Age > 18 and direct contact to deceased patient in the last phase of life (independent of sex) d. Stakeholder in health region Employed at least 1 year at interface to GPs practice (nursing service, nursing homes, hospitals, surgery) (independent of sex) e. Health insurance data Patient deceased as a result of life-limiting, chronic progressive oncological and non-oncological diseases within ZIP-Code of the targeted Region in 2016/2017 (t=0) or 2019/2020 (t=1), continuously assured, age > 18 (independent of sex)
Exclusion criteria
Exclusion criteria: b. and e.: Sudden death, which is not related to a life-limiting, chronic progressive oncological and non-oncological disease (e.g. traffic accident, heart attack without diagnosis of coronary heart disease)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| a.) Optimized care at the end of life- General practitioners perspective: GP-EoLC-I, written survey of the project’s general practitioners – Dimensions: clinical practice of the general practitioners, organization of palliative care (t=0 six months pre interventionem, t=1 six month post-interventionem) | — |
Secondary
| Measure | Time frame |
|---|---|
| a. Optimized care in the last phase of life – relatives perspective Situation of care, involvement in therapeutical decisions, Advanced-Care-Planning, consideration of therapeutic preferences, preferred place of living in the end of life and place of death, after- death- interviews (t0 six month pre interventionem, t1 six month post interventionem) b. Optimized care of patients at the end of life (Palliative-) Care- Indicators at the end of life, similar to the Bertelsmann-Stiftung’s facts-checking (2015) about routine data of the GP practice in the health region (t0 six month pre interventionem, t1 six month post interventionem) and AOK-data for a regional comparative analysis (t0 twelve month pre interventionem, t1 twelve month post interventionem) - Chemotherapy while the last month of life of cancer patients, - PEG-device while the last three month of life of dementia-patient, - Number of hospital stays and days of hospital care in the last 6 month of life, - Number of patients with EBM-treatments within AAPV, - Number of SAPV-first-prescription’s and SAPV-first-prescription’s within the last three days of life, - Average duration of SAPV-treatments, - Number of patients who deceased in hospital c. Acceptance and usage of SPICT: Number of cases in GP practice, where SPICT was used to assess the palliative situation, analysis of documents of patient files (6 month post interventionem) d. GP’s awareness and sensibility for palliative situations: Number of patients, who are eligible for palliative care, number of AAPV-cases and SAPV-prescriptions, analysis of documents of patients files and GKV-data (t0 six month pre interventionem, t1 post interventionem) e. Effectiveness- practical consequences for GPs: Number of initiate interventions for patients with life-limiting, chronic progressive oncological and non-oncological diseases, e.g. medication review, Advanced-Palliative-Care, structured survey of demand, prescription of SAPV, analysis of documents of pat | — |
Countries
Germany
Contacts
Public ContactKambiz Afshar
Medizinische Hochschule Hannover
Outcome results
None listed