Abstract
BackgroundPalliative care should be provided according to the individual needs of the patient, caregiver and family, so that the type and level of care provided, as well as the setting in which it is delivered, are dependent on the complexity and severity of individual needs, rather than prognosis or diagnosis [1]. This paper presents a study designed to assess the feasibility and efficacy of an intervention to assist in the allocation of palliative care resources according to need, within the context of a population of people with advanced cancer.Methods/designPeople with advanced cancer and their caregivers completed bi-monthly telephone interviews over a period of up to 18 months to assess unmet needs, anxiety and depression, quality of life, satisfaction with care and service utilisation. The intervention, introduced after at least two baseline phone interviews, involved a) training medical, nursing and allied health professionals at each recruitment site on the use of the Palliative Care Needs Assessment Guidelines and the Needs Assessment Tool: Progressive Disease - Cancer (NAT: PD-C); b) health professionals completing the NAT: PD-C with participating patients approximately monthly for the rest of the study period. Changes in outcomes will be compared pre-and post-intervention.DiscussionThe study will determine whether the routine, systematic and regular use of the Guidelines and NAT: PD-C in a range of clinical settings is a feasible and effective strategy for facilitating the timely provision of needs based care.Trials registrationISRCTN21699701
Highlights
Palliative care should be provided according to the individual needs of the patient, caregiver and family, so that the type and level of care provided, as well as the setting in which it is delivered, are dependent on the complexity and severity of individual needs, rather than prognosis or diagnosis [1]
The health care experiences of people with life limiting illnesses have become a primary concern in recent years, with literature suggesting that the management of advanced cancer is lacking in terms of access [2]
Providing care on the basis of needs offers a way to ensure that the finite specialist palliative care resources available are provided to those people who need them most [3], while allowing less complex needs to continue to be met by primary care or allied health services
Summary
Palliative care should be provided according to the individual needs of the patient, caregiver and family, so that the type and level of care provided, as well as the setting in which it is delivered, are dependent on the complexity and severity of individual needs, rather than prognosis or diagnosis [1]. The need to provide palliative care in a more accessible and equitable manner has led to Palliative Care Australia (PCA) recommending a more needs-based model [1]. This model offers a way to improve the delivery of palliative care by triaging people with life limiting illnesses such as cancer according to complexity of their needs. Providing care on the basis of needs offers a way to ensure that the finite specialist palliative care resources available are provided to those people who need them most [3], while allowing less complex needs to continue to be met by primary care or allied health services. Patients with minimal needs can continue to be cared for by their primary care team; while those with intermediate or complex needs may require the consultative or continued involvement of specialist providers [1]
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