Impact of Interprofessional Training and Co-ordination on Early Identification and Proactive Approach to End-of-life Situations in the Context of Primary Care

NCT ID: NCT03171779

Last Updated: 2025-04-02

Basic Information

• Recruitment Status: RECRUITING
• Total Enrollment: 58 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2015-06-17
• Study Completion Date: 2027-10-18

Brief Summary

More than 300,000 people die each year in France from a disease that may require palliative care. Nevertheless, only a small proportion of these patients are able to access this care, in particular because of a too late identification.

While several factors may hinder access to specialized palliative care resources, one of the major barriers to the initiation of palliative care, and particularly to the implementation of quality end-of-life care, Remains the failure to recognize that patients with advanced chronic illness are actually approaching the end of their lives.

However, it is now clearly established that early integration of palliative care in the care of people living with a serious, incurable and progressive disease:

• has an impact on the quality (and sometimes the expectation) of life of these people,
• avoids aggressive treatments and unplanned hospitalizations,
• is associated with lower health costs than other end-of-life patients. Primary health care providers have a major role to play in facilitating access to palliative care, but their practice has been hampered in our country by the fragmented and poorly coordinated nature of primary care and Negligible in terms of training. However, they remain the first contact of the patients with the system of care, and are also structuring for the continuation of the patient's journey within the health system.

The first hypothesis is that the work of genuine interprofessional primary care teams in multi-professional health centers (MSPs), coupled with adequate training in the use of simple tools, can contribute to the early identification of patients approaching End of life, to meet their palliative care needs.

However, various European programs (Gold Standards Framework in the UK, NECPAL in Catalonia, RADPAC in the Netherlands) have shown that identification alone is not enough to increase access to specialized palliative care. The second hypothesis is that it must be articulated for this with a training of the professionals to carry out conversations of anticipated planning of the care with their patients.

Conditions

Interprofessional Relations; End-of-life Situations

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: PROSPECTIVE

Study Groups

Usual practice

Patients approaching the end of their lives

Intervention Type: OTHER

To determine whether the use of simple tools by a primary care team for the early identification of end-of-life patients can improve access to specialized palliative care resources

IPEM

Interprofessional Training in Early Identification and Multidimensional Evaluation (IPEM) of patients' palliative needs

Patients approaching the end of their lives

Intervention Type: OTHER

To determine whether the use of simple tools by a primary care team for the early identification of end-of-life patients can improve access to specialized palliative care resources

IPEM and PAS

Interprofessional Early Identification Training and Multidimensional Assessment (IPEM) of patients' palliative needs, and to the Early Care Planning (SAP)

Patients approaching the end of their lives

Intervention Type: OTHER

To determine whether the use of simple tools by a primary care team for the early identification of end-of-life patients can improve access to specialized palliative care resources

Interventions

Patients approaching the end of their lives

To determine whether the use of simple tools by a primary care team for the early identification of end-of-life patients can improve access to specialized palliative care resources

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Being a multi-professional health care home (MSP)
• At least one specialized palliative care resource available in the MSP territory (USP, EMSP, palliative care network)

Exclusion Criteria

• Health centers, group medical practices, clinics
• Less than 3 general practitioners (GPs) and / or absence of nurses (FDI) within the MSP

• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Centre Hospitalier Universitaire, Amiens

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Locations

CHU Amiens Picardie

Amiens, Picardie, France

Site Status: RECRUITING

Countries

France

Central Contacts

Maxime GIGNON, Dr

Role: CONTACT

gignon.maxime@chu-amiens.fr

+33322667606

Facility Contacts

Maxime GIGNON, Dr

Role: primary

gignon.maxime@chu-amiens.fr

+33322667606

Other Identifiers

PI2015_843_0038

Identifier Type: -

Identifier Source: org_study_id