A Shared Care Approach for Seriously Ill Cancer Patients Between General Practice, Discharge Department and a Specialist Palliative Care Team

Summary

Background:

Approximately one third of all deaths in Denmark are caused by cancer. Both Danish and international research shows that the majority of terminally ill cancer patients wish to die at home. In Denmark only about 25% has this wish fulfilled. The General Practitioner (GP) has traditionally had the full responsibility for the palliative care of terminally ill cancer patients. In recent years changes have been made to the organisation of palliative care: some hospitals have set up specialised palliative care teams and in some areas of Denmark hospices have been established.

Recent research defines a problem when it comes to communication between the hospital and general practice when the patient is being discharged. This is often done in a way that can cause the patient to feel "left in limbo", especially if it is not completely clear to the patient and his or her relatives who has the responsibility for the palliative care.

Objective:

1. To describe consequences for patients, relatives and health care professionals of three different ways of organising palliative care
2. To collect data which describes patients who are candidates to a shared care approach between general practice and a specialised palliative care team
3. To collect data which describes the palliative phase (place of death and palliative care, admissions to hospital, involvement of GP and district nurse etc.)
4. To describe terminally ill cancer patients and their relatives expectations of the health care system

270 terminally ill cancer patients will be invited to take part in the study. Data will be collected by interview with patients and questionnaires for patients, relatives and involved health care professionals.

Conditions

• Palliative Care
• Neoplasms

Interventions

OTHER

Organisational intervention

A shared care approach in which extra effort is put into improving the communication between the hospital and the primary sector.

OTHER

Referral to a specialist palliative care team.

Discharge with referral to a specialist palliative care team. This is a patient-centred shared care model in which the palliative team helps to organise the patient's treatment and care.

Sponsors & Collaborators

• Research Unit for General Practice, Aarhus University

  collaborator OTHER

• Aarhus University Hospital

  collaborator OTHER

• University of Aarhus

  lead OTHER

Principal Investigators

• Frede Olesen, Professor · Research Unit for General Practice, Aarhus University

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

FACTORIAL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2008-04-30

Primary Completion

2009-10-31

Completion

2010-11-30