[Pilot Project: Reinforcement of Outpatient Palliative Care in the State of Brandenburg - An Analysis of Documentation Data of Primary Palliative Care]. / Pilotprojekt zur Stärkung der ambulanten Palliativversorgung im Land Brandenburg ­ Analyse von Dokumentationsdaten der allgemeinen ambulanten Palliativversorgung.

BACKGROUND: Quantitative data on primary palliative care (AAPV) in Germany is scarce. In order to reinforce outpatient palliative care, a pilot project was implemented and evaluated in 2 regions of Brandenburg. The aim of this study was to gain an insight into AAPV based on documentation data from the pilot project: How was AAPV realized in the pilot project? How does the implementation of AAPV differ in the 2 project regions? MATERIALS AND METHODS: The study is based on retrospective analysis of the data on 108 patients documented by 13 physicians in 2 regions of Brandenburg using PalliDoc® software. The results were analysed by descriptive statistical methods. RESULTS: Each participating doctor documented the care process of 7.7 patients on average during the observation period. Overall, about 66% of the patients were diagnosed with a tumour as the main diagnosis. The average duration of care for patients in the pilot project was 171.3 days. On average, doctors documented 9.1 contacts per patient with contacts lasting 20:28 min. The average route to the patient was 9.3 kilometres. CONCLUSIONS: Our results indicate that the execution of AAPV is highly dependent on regional circumstances as well as on the existing offers and services of hospice and palliative care. Compared to data from the evaluation of palliative care teams in other German regions, it appears that the care processes in AAPV last longer and a larger number of patients without underlying oncological disease has been treated under AAPV than in specialized palliative care.

["If they were to stop coming, I'd panic" : Palliative care networks from the perspectives of patients and informal care givers]. / "Wenn die mal nicht mehr kommen würden, dann kriege ich eine Krise" : Netzwerke der ambulanten Palliativversorgung aus Sicht von Patienten und Angehörigen.

OBJECTIVE: This study examines the perspectives of patients and family caregivers on outpatient palliative care networks. It contrasts primary palliative care (AAPV) and specialized outpatient care (SAPV) services, particularly in regard to pain management. METHODS: The study is based on 27 semi-structured, problem-focussed interviews with 21 patients and 19 informal caregivers. Recruitment was based on purposive sampling in two regions of Brandenburg, Germany. The data were analysed using qualitative content analysis. RESULTS: In AAPV, the general practitioner (GP) is both the central point of contact as well as the coordinator of the care network. In SAPV, the GP plays a less important role. This can lead to conflicts between GPs and health care professionals of the palliative care team. Compared to AAPV, palliative care teams are attributed greater intervention capacities in acute situations as well as expertise in pain therapy. Thus, the option of parenteral administration of opioids is considered a benefit of specialized care. The use of nursing services varies considerably depending on the individual care network-in some cases care is completely taken over by relatives. Relatives are the closest to the patient within the care network and perform key tasks. CONCLUSION: The personal and professional composition of networks of outpatient palliative care varies individually according to care situation and form. Care networks of AAPV and SAPV differ with regard to the accessibility of health care professionals and pain therapy. Home-based palliative care is often made possible by informal care givers in the first place.