The PAMINO-project: evaluating a primary care based educational program to improve the quality of life of palliative patients

Conditions

Oncological diseases Cancer Palliative care

Katja Krug, Antje Miksch, Frank Peters-Klimm, Peter Engeser, Joachim Szécsényi

BMC Palliative Care2016-01-15133 citations

[Symptom control and place of death in palliative cancer patients in primary care. Results of the controlled PAMINO evaluation study].

Engeser P, Hermann K, Szecsenyi J, Peters-Klimm F.

2014-12-013 citations

10.1007/s00482-014-1464-9

Palliative patients cared for at home by PAMINO-trained and other GPs - health-related quality of life as measured by QLQ-C15-PAL and POS.

Hermann K, Engeser P, Szecsenyi J, Miksch A.

2012-08-219 citations

10.1186/1472-684x-11-13

The PAMINO-project: evaluating a primary care-based educational program to improve the quality of life of palliative patients.

Rosemann T, Hermann K, Miksch A, Engeser P, Szecsenyi J.

2007-05-2911 citations

10.1186/1472-684x-6-5

Interventions

This study compares the outcomes between a multifaceted-based interdisciplinary training concept in palliative care in a primary care setting and usual palliative care for patients with malignant tumo

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: 1. The GPs participating in the study include consecutively adult outpatients (at least 18 years of age) of whom they are the family physician 2. Patients need to be in a palliative situation with an oncological disease 3. They have to give their informed and written consent to participate 4. Estimated life expectancy is six months at most

Exclusion criteria

Exclusion criteria: 1. Patients with malignant tumours in a curative therapy situation or with an additional uncontrolled disease with a lower life expectancy than the tumour disease 2. Insufficient German language skills

Design outcomes

Primary

Measure	Time frame
As the primary outcome parameter, we observe the change of quality of life of patients in the intervention group (patients of general practitioners with PAMINO-training) compared to the control group (patients of general practitioners without PAMINO-training). Quality of life will be assessed by the German version of the Palliative care Outcome Scale (POS), and the Quality of Life Questionnaire Core-15 Palliative care (QLQ-C15-PAL) of the European Organisation for Research and Treatment of Cancer (EORTC). All assessement tools (for patients, physicians, and family caregivers) are administered monthly from enrolment to either death of the patient or the end of the six-month observation period.	—

Measure

Time frame

As the primary outcome parameter, we observe the change of quality of life of patients in the intervention group (patients of general practitioners with PAMINO-training) compared to the control group (patients of general practitioners without PAMINO-training). Quality of life will be assessed by the German version of the Palliative care Outcome Scale (POS), and the Quality of Life Questionnaire Core-15 Palliative care (QLQ-C15-PAL) of the European Organisation for Research and Treatment of Cancer (EORTC). All assessement tools (for patients, physicians, and family caregivers) are administered monthly from enrolment to either death of the patient or the end of the six-month observation period.

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Secondary

Measure	Time frame
The training will have an effect on the following secondary outcomes: 1. A lower pain level as experienced by the patients and assessed by a Visual Analogue Scale (VAS) 2. Lower burden for family caregivers as assessed by the Burden Scale for Family Caregivers (BSFC) 3. Less utilisation of the health care system (primary and specialist care, nursing service) including emergency and hospital admittance 4. In a higher proportion of patients the favoured and actual site of death concur The effects of the training on the following process indicators are observed: 1. Drug therapy, especially for pain, in adherence to the guidelines of the World Health Organisation (WHO) 2. Therapeutic elements of palliative medicine besides drug therapy 3. The existence of documents such as advance directives, do-not-resuscitate orders, and health care proxy, treatment plan 4. Prescription of pain medication 5. Realisation of substitution in case of unavailability of the treating family physician 6. Cooperation with nursing services All assessement tools (for patients, physicians, and family caregivers) are administered monthly from enrolment to either death of the patient or the end of the six-month observation period.	—

Measure

Time frame

The training will have an effect on the following secondary outcomes: 1. A lower pain level as experienced by the patients and assessed by a Visual Analogue Scale (VAS) 2. Lower burden for family caregivers as assessed by the Burden Scale for Family Caregivers (BSFC) 3. Less utilisation of the health care system (primary and specialist care, nursing service) including emergency and hospital admittance 4. In a higher proportion of patients the favoured and actual site of death concur The effects of the training on the following process indicators are observed: 1. Drug therapy, especially for pain, in adherence to the guidelines of the World Health Organisation (WHO) 2. Therapeutic elements of palliative medicine besides drug therapy 3. The existence of documents such as advance directives, do-not-resuscitate orders, and health care proxy, treatment plan 4. Prescription of pain medication 5. Realisation of substitution in case of unavailability of the treating family physician 6. Cooperation with nursing services All assessement tools (for patients, physicians, and family caregivers) are administered monthly from enrolment to either death of the patient or the end of the six-month observation period.

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Countries

Germany

Outcome results

None listed