Abstract
BackgroundFor GPs to implement early palliative care, the first step is to identify patients with palliative care needs. The surprise question (SQ) is a screening tool that aims to aid this identification; for example, a response of 'no' to the SQ — 'Would you be surprised if this patient would die within a year?' — would suggest palliative care may be needed.AimTo describe setting-specific screening results of patients eligible for early palliative care in family practices, which is defined as patients aged ≥45 years with GPs' responses of 'no' to the SQ.Design & settingA secondary analysis was undertaken using a cross-sectional descriptive study in family practices in five areas in Belgium.MethodGPs were recruited by targeted sampling. As a first part of an implementation research project, participating GPs provided demographic information about themselves and also provided a response to the SQ for all patients who came to the practice in 10 consecutive office days. A summary table describing the sex, age, location of contact (GP surgeries, patients' homes, or nursing homes) of the patients was provided by each GP.ResultsFifty-six GPs provided complete data for the practice summary tables. In total, 9150 patients were described (all ages, all settings), of which 506 patients (6%) had a GP response of 'no' to the SQ. The distribution of SQ-no-as-answer patients per setting was: 152/7659 (2%) patients seen in family practice surgeries; 139/998 (14%) patients seen in their homes; and 215/493 (44%) patients seen in nursing homes.ConclusionThere was a large number of patients with SQ-no-as-answer, with possible palliative care needs. To enhance implementation of early palliative care, future research should compare results of SQ and other screening tools with palliative care symptoms assessments.
Highlights
Offering palliative care to patients should be based on palliative care needs rather than on a terminal prognosis
The distribution of surprise question (SQ)-n o-as-a nswer patients per setting was: 152/7659 (2%) patients seen in family practice surgeries; 139/998 (14%) patients seen in their homes; and 215/493 (44%) patients seen in nursing homes
There was a large number of patients with SQ-n o-a s-answer, with possible palliative care needs
Summary
Offering palliative care to patients should be based on palliative care needs rather than on a terminal prognosis. This is considered a task for all physicians, and for GPs because they are in close contact with the largest part of the population.[1]. For GPs to implement early palliative care, the first step is to identify patients with palliative care needs. The surprise question (SQ) is a screening tool that aims to aid this identification; for example, a response of 'no' to the SQ — 'Would you be surprised if this patient would die within a year?' — would suggest palliative care may be needed
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