Integrating early palliative care into routine practice for patients with cancer: A mixed methods evaluation of the INTEGRATE Project.
Psychooncology
; 28(6): 1261-1268, 2019 06.
Article
em En
| MEDLINE
| ID: mdl-30946500
ABSTRACT
OBJECTIVE:
With increasing evidence from controlled trials on benefits of early palliative care, there is a need for studies examining implementation in real-world settings. The INTEGRATE Project was a 3-year real-world project that promoted early identification and support of patients with cancer who may benefit from palliative care. This study assesses feasibility, stakeholder experiences, and early impact of the INTEGRATE ProjectMETHODS:
The INTEGRATE Project was implemented in four cancer centers in Ontario, Canada, and consisted of interdisciplinary provider education and an integrated care model. Providers used the Surprise Question to identify patients for inclusion. A mixed methods evaluation of INTEGRATE was conducted using descriptive data, interviews with providers and managers, and provider surveys.RESULTS:
A total of 760 patients with cancer (lung, glioblastoma, head and neck, gastrointestinal) were included. Results suggest improvement in provider confidence to deliver palliative care and to initiate the Advanced Care Planning (ACP) conversation. The majority of patients (85%) had an ACP or goals of care (GOC) conversation initiated within a mean time to conversation of 5-46 days (SD 20-93) across centers. A primary care report was transmitted to family doctors 48-100% of the time within a mean time to transmission of 7-54 days (SD 9-27) across centers. Enablers and barriers influencing success of the model were also identified.CONCLUSIONS:
A standardized model for the early introduction of palliative care for patients with cancer can be integrated into the routine practice of oncology providers, with appropriate education, integration into existing clinical workflows, and administrative support.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Cuidados Paliativos
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Planejamento de Assistência ao Paciente
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Educação de Pacientes como Assunto
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Prestação Integrada de Cuidados de Saúde
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Planejamento Antecipado de Cuidados
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Neoplasias
Tipo de estudo:
Clinical_trials
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Evaluation_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article