Abstract
BackgroundPatients with advanced chronic non-malignant conditions often experience significant symptom burden. Therefore, overcoming barriers to interprofessional collaboration between general practitioners (GPs) and specialist palliative home care (SPHC) teams is essential to facilitate the timely integration of palliative care elements. The KOPAL trial aimed to examine the impact of case conferences between GPs and SPHC teams on symptom burden and pain in patients with advanced chronic heart failure, chronic obstructive pulmonary disease, and dementia.MethodsThe cluster-randomised controlled trial compared a structured palliative care nurse visit followed by an interprofessional case conference to usual care. Data were collected from GPs at baseline and 48 weeks, while standardised patient interviews were conducted at baseline, 6, 12, 24, and 48 weeks.ResultsWe analysed 172 patients from 49 German GP practices. Both groups showed marginal improvement in symptom burden; however, no statistically significant between-group difference was found (=-0.561, 95% CI: -3.201–2.079, p = .68). Patients with dementia experienced a significant pain reduction (=2.187, 95% CI: 0.563–3.812, p = .009). Conversely, the intervention did not have a significant effect on pain severity (=-0.711, 95% CI: -1.430 − 0.008, p=.053) or pain interference (=-0.036, 95% CI:-0.797 − 0.725, p=.926) in other patient groups.ConclusionsThe intervention showed promise in the timely introduction of palliative care elements to address pain management in patients with dementia. Further studies are needed to identify and effectively address symptom burden and pain in other patient groups.Trial registrationGerman Clinical Trials Register: https://www.drks.de/DRKS00017795 (Registration date: 9th January 2020).
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call