scholarly journals Clinical Effectiveness of Online Training in Palliative Care of Primary Care Physicians

2013 ◽  
Vol 16 (10) ◽  
pp. 1188-1196 ◽  
Author(s):  
Marta Pelayo-Alvarez ◽  
Santiago Perez-Hoyos ◽  
Yolanda Agra-Varela
Keyword(s):  
Primary Care ◽  
Palliative Care ◽  
Primary Care Physicians ◽  
Clinical Effectiveness ◽  
Online Training

scholarly journals Availability of home palliative care services and dying at home in conditions needing palliative care: A population-based death certificate study

2020 ◽  
Vol 34 (4) ◽  
pp. 504-512 ◽  
Author(s):  
Miharu Nakanishi ◽  
Asao Ogawa ◽  
Atsushi Nishida
Keyword(s):  
Primary Care ◽  
Palliative Care ◽  
Primary Care Physicians ◽  
Death Certificate ◽  
Care Services ◽  
Primary Care Services ◽  
Hospital Beds ◽  
Palliative Care Services ◽  
Dying At Home ◽  
At Home

Background: Avoiding inappropriate care transition and enabling people with chronic diseases to die at home have become important health policy issues. Availability of palliative home care services may be related to dying at home. Aim: After controlling for the presence of hospital beds and primary care physicians, we examined the association between availability of home palliative care services and dying at home in conditions requiring such services. Design: Death certificate data in Japan in 2016 were linked with regional healthcare statistics. Setting/participants: All adults (18 years or older) who died from conditions needing palliative care in 2016 in Japan were included. Results: There were 922,756 persons included for analysis. Malignant neoplasm (37.4%) accounted for most decedents, followed by heart disease including cerebrovascular disease (31.4%), respiratory disease (14.7%) and dementia/Alzheimer’s disease/senility (11.5%). Of decedents, 20.8% died at home or in a nursing home and 79.2% died outside home (hospital/geriatric intermediate care facility). Death at home was more likely in health regions with fewer hospital beds and more primary care physicians, in total and per condition needing palliative care. Number of home palliative care services was negatively associated with death at home. The adjustment for home palliative care services disappeared in heart disease including cerebrovascular disease and reversed in respiratory disease. Conclusion: Specialised home palliative care services may be suboptimal, and primary care services may serve as a key access point in providing baseline palliative care to people with conditions needing palliative care. Therefore, primary care services should aim to enhance their palliative care workforce.

scholarly journals Effects of online palliative care training on knowledge, attitude and satisfaction of primary care physicians

2011 ◽  
Vol 12 (1) ◽  
Author(s):  
Marta Pelayo ◽  
Diego Cebrián ◽  
Almudena Areosa ◽  
Yolanda Agra ◽  
Juan Vicente Izquierdo ◽  
...  
Keyword(s):  
Primary Care ◽  
Palliative Care ◽  
Primary Care Physicians ◽  
Care Training

scholarly journals The chronic need to improve the management of pain

2003 ◽  
Vol 8 (4) ◽  
pp. 187-188 ◽  
Author(s):  
Eldon Tunks
Keyword(s):  
Primary Care ◽  
Palliative Care ◽  
Primary Care Physicians ◽  
Opioid Analgesics ◽  
Care Practice ◽  
Eligibility Criteria ◽  
Chronic Noncancer Pain ◽  
Primary Care Doctors ◽  
Third Line ◽  
Noncancer Pain

In this issue, Drs Morley-Forster, Clark, Speechley and Moulin report on their survey conducted by Ipsos-Reid in June 2001 (pages 189-194). Only physicians who met the eligibility criteria of having written 20 or more prescriptions for moderate to severe pain in the preceding four weeks or having devoted 20% of their time to palliative care were eligible to participate. Sixty-eight per cent of the respondents thought that moderate to severe chronic pain was not well managed in Canada. Despite this opinion, 23% of physicians in palliative care practice and 34% of primary care doctors stated that they would not use opioids to treat moderate to severe chronic noncancer pain even as a third-line treatment after two previous medications had failed. One-quarter to one-third were concerned about the potential for addiction, and a smaller percentage reported concern about the potential for patient abuse and/or misuse, and side effects. Fear of a College audit resulting in the loss of their medical licence was cited by 10% of primary care physicians. When asked what obstacle hindered their use of strong opioid analgesics, an unexplained 10% of palliative care doctors and 14% of primary care doctors answered "nothing in particular".

scholarly journals Knowledge and Attitude of Primary Care Physicians towards Palliative Care. Is it time for integration?

2021 ◽  
Author(s):  
Ameena Mohammed Al-Ansari ◽  
Wafaa Mostafa Abd-El-Gawad ◽  
Saleem Nawaf Suroor ◽  
Sobhi Mostafa AboSerea
Keyword(s):  
Primary Care ◽  
Palliative Care ◽  
Primary Care Physicians ◽  
Health Care Systems ◽  
Knowledge Score ◽  
P Value ◽  
Care Services ◽  
Palliative Care Services ◽  
Care Systems ◽  
Knowledge And Attitude

Abstract Background Although the primary care physicians’ role in delivering the majority of care with high-quality service for patients under palliative care is unquestionable, it is not clear what their current level of knowledge and attitude toward palliative care is. Aim To recognize the primary care physicians’ knowledge and attitude toward palliative care in Kuwait. Design and Setting: National survey using stratified random sampling was performed. A total of 25 primary care clinics in Kuwait were selected and 284 primary care physicians were recruited. Method: Palliative Care Attitude and Knowledge questionnaire (PCAK) were distributed to them. Their attitude and knowledge were measured. predictors of better attitude were assessed. Results The response rate was 79.2%(n = 225). 53.3%(n = 120) of primary care physicians had an uncertain attitude towards palliative care while only 15(6.7%) had good knowledge. Only 5.7% and 25.5% reported excellent or very good experience in the management of pain and other symptoms respectively. Moreover, 141(62.7%) and 119(52.9%) were not familiar with palliative care services in their community or length and types of coverage under palliative care benefits. Less than 50% responded correctly to the questions regarding the proper management of catastrophic bleeding, opioid initiation, types, toxicity and its role in refractory dyspnea. Higher knowledge score was a positive predictor for more positive attitude scores (OR:1.088, 95% CI: 1.012–1.170,P value: 0.023). Conclusion The majority of primary care physicians had uncertain attitude and poor knowledge towards palliative care. Integrating palliative care into primary health care systems is urgently needed to alleviate the suffering of those patients.

Identification and management of depression in primary care settings. A meta-review of evidence

2006 ◽  
Vol 15 (4) ◽  
pp. 276-283 ◽  
Author(s):  
Corrado Barbui ◽  
Michele Tansella
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Management Strategies ◽  
Severe Depression ◽  
Population Level ◽  
Clinical Effectiveness ◽  
Evidence Base ◽  
Care Staff ◽  
Primary Care Settings ◽  
Meta Review

SummaryAim– The purpose of this review is to summarize the evidence base on the effectiveness of (a) screening for depression in primary care; (b) managing depression in primary care employing specific management strategies; (c) treating primary care depressive patients with antidepressants.Methods– Meta-review of all available reviews of the evidence.Results– Screening alone does not improve the recognition, management and outcome of depression in primary care settings. Management strategies, including (a) training primary care staff, (b) consultation-liaison, (c) collaborative care, (d) replacement/referral are supported by insufficient evidence to provide a definite answer as to the clinical effectiveness of individual models. Robust evidence exists to encourage physicians to prescribe effective doses of antidepressants in patients with moderate to severe depression who seek treatment in primary care settings.Conclusion– Population-level screening campaigns have a negative ratio of costs to benefits. However, at an individual-level of care increasing the ability of primary care physicians in recognising depression remains a relevant factor. Primary care physicians should consider whether depression is mild, moderate or severe. This patient categorisation help develop appropriate management and therapeutic strategies.Declaration of Interest: none

scholarly journals Trials and Tribulations: Palliative Care Trial Recruitment Approaches and Challenges

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 167-167
Author(s):  
Anna Rahman ◽  
Sindy Lomeli ◽  
Susan Enguidanos
Keyword(s):  
Primary Care ◽  
Palliative Care ◽  
Primary Care Physicians ◽  
Controlled Trial ◽  
Trial Recruitment ◽  
Patient Identification ◽  
Patient Centered ◽  
Recruitment Methods ◽  
Home Based ◽  
Training And Support

Abstract In 2017, we received funding form the Patient-Centered Outcomes Research Institute to conduct a large, state-wide, randomized controlled trial to test the effectiveness of a home-based palliative care (HBPC) program within accountable care organizations. Participants were randomized to either HBPC or enhanced usual care, where physicians were provided added training and support in core palliative care practices. Originally, we planned to obtain patient referrals to the trial from primary care physicians, however we were unable to engage primary care physicians in patient identification processes. In this session we will describe the numerous trial modifications made to our trial recruitment methods and the success of each approach. Ultimately, after 20 months of trial recruitment, we had recruited just 28 patients and 10 of their caregivers. Findings from this terminated trial may inform other researchers in development of participant recruitment methods.

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