Early identification of patients in need of palliative care in slovenian general practice
Article Category: Original scientific article
Published Online: Apr 12, 2018
Page range: 55 - 64
Received: Apr 19, 2017
Accepted: Jan 15, 2018
DOI: https://doi.org/10.2478/sjph-2018-0008
Keywords
© 2018 National Institute of Public Health, Slovenia
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
Background
To help general practitioners (GPs) in early identification of patients with palliative care (PC) needs, this pilot study aimed to determine the potential of the combined original surprise question (SQ1) (‘Would I be surprised if this patient died within the next 12 months?’) and the second surprise question (SQ2) (‘Would I be surprised if this patient was still alive after 12 months?’). We hypothesized that answering these SQs would trigger them to make a multidimensional care plan.
Methods
26 Slovenian GPs, randomized into 4 groups, were invited to write a care plan for each of the four patients described in case vignettes (2 oncologic, 1 organ failure and 1 frailty case). GPs in group 1 were only asked to write a care plan for each patient. GPs in group 2 answered SQ1 and GPs in groups 3 and 4 answered SQ1 and SQ2 before writing the care plan. The type and number of PC aspects mentioned in the respective care plans were quantified into a numeric RADboud ANTicipatory (RADIANT) score.
Results
Mean RADIANT scores in groups 1-4 were 2.2, 3.6, 2.5 and 3.1, respectively. When comparing the different vignettes, vignette B (terminal oncologic patient) scored best (3.6). Mean RADIANT scores in groups 3 and 4 were slightly higher for GPs who would be surprised compared to GPs who would not be surprised if the patient was still alive in 12 months.
Conclusion
The combined SQs were considered helpful in the early identification of patients in need of PC in Slovenian general practice.