Improving End-of-life Care by Continuing Medical Education and Electronic Decision Making Support for General Practitioners

Improving End-of-life Care by Continuing Medical Education and Electronic Decision Making Support for General Practitioners in Denmark - an Intervention Study

Background: Optimizing the basic palliative care has been shown beneficial to patients in end-of-life care, the general practitioner (GP) having a pivotal role in the health care system, providing comprehensive and continued medical care.

The aim of the study is to investigate the effect of a complex intervention in general practice on GPs' awareness of and confidence in providing end-of-life care.

Method: A follow-up study among 404 general practices in Central Denmark Region. The participating general practices will get the opportunity to receive education in palliative care and access to an electronic support, which provides advice on palliative care and an overview of the palliative population in each medical practice. The education and the support will focus on patients suffering from either metastatic cancer or chronic obstructive pulmonary disease (GOLD stage 4).

The end-of-life care delivered by the GPs to their deceased patients will be analysed, based on questionnaires to GPs and register data related to the deceased patients before and after the intervention, .

Primary outcomes: Place of death of deceased patients, time spent at home, and number of hospital admissions in the last three months of the patients' lives.

Secondary outcomes: Number and kinds of contacts between GPs and patients, use of relevant medicine and of the 'Safety Box'. Finally GPs' confidence concerning palliative care will be assessed in questionnaires.

Study Overview

• Status: Withdrawn
• Conditions: Chronic Obstructive Pulmonary Disease; Metastatic Cancer
• Intervention / Treatment: Other: continuing medical education and electronic decision support; Other: education and electronic support

• Study Type: Interventional
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Denmark
  • Aarhus, Denmark, 8000
    • Aarhus University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

Working as General Practitioner in the Central Region of Denmark in 2013 and onwards

-

Exclusion Criteria:

-

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: general practioner	Other: continuing medical education and electronic decision support; Other: education and electronic support; Continuing medical education and electronic decision support to General Practitioners.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Place of death of deceased patients	Looking at the proportion of General practitioners patients dying at home in the year following the continuing medical education meeting	1 year
time spent at home the last three months of the deceased patients lives	Looking at all the deceased patients in one year following the continuing medical education meeting	3 months
Numbers of hospital admission the last three months of the deceased patients lives	Looking at all the deceased patients in one year following the continuing medical education meeting	3 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
and kinds of contacts between GPs and patients in the last three months of the deceased patients lives		three months
use of relevant medicine and of the 'Safety Box' in the last three months of the deceased patients lives		three months
GPs' confidence concerning palliative care	assessed using questionnaire before and after the intervention	14 months

Collaborators and Investigators

• Sponsor: University of Aarhus
• Collaborators: Danish Cancer Society; TrygFonden, Denmark
• Investigators: Principal Investigator: Anders B. Mr Jensen, Professor, Department of Oncology, Aarhus University Hospital, Denmark

Publications and helpful links

General Publications

• Winthereik AK, Neergaard MA, Jensen AB, Vedsted P. Development, modelling, and pilot testing of a complex intervention to support end-of-life care provided by Danish general practitioners. BMC Fam Pract. 2018 Jun 20;19(1):91. doi: 10.1186/s12875-018-0774-x.

Study record dates

Study Major Dates

• Study Start: February 1, 2014
• Primary Completion (Actual): December 1, 2014
• Study Completion (Actual): December 1, 2014

Study Registration Dates

• First Submitted: December 18, 2013
• First Submitted That Met QC Criteria: January 28, 2014
• First Posted (Estimate): January 30, 2014

Study Record Updates

• Last Update Posted (Estimate): December 11, 2014
• Last Update Submitted That Met QC Criteria: December 10, 2014
• Last Verified: December 1, 2013

More Information

Terms related to this study

• Keywords: Palliative care; General practitioner; Continuing medical education; Electronic decision support
• Additional Relevant MeSH Terms: Pathologic Processes; Respiratory Tract Diseases; Lung Diseases; Lung Diseases, Obstructive; Pulmonary Disease, Chronic Obstructive; Death
• Other Study ID Numbers: 2006802748