PROject - Supportive and Palliative Care and INnOvation - Antwerp (Pro-Spinoza)

Study Overview
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Brief Summary
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It is important to provide high quality palliative care to all patients with a non-curable and life-limiting condition. The Care Pathway for Primary Palliative Care (CPPPC) provides tools for health care professionals to help them delivering palliative care timely and accurately.This study investigates whether the implementation of the CPPPC really helps to improve patients' lifes.

Official Title
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Implementation of the Care Pathway for Primary Palliative Care in Five Research Clusters in Belgium

Conditions
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Palliative Care, Primary Health Care

Intervention / Treatment
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* Other: Care Pathway for Primary Palliative Care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: identified as a palliative care patient using the Surprise Question Would you, as a family doctor, be surprised if this patient would die in the next 12 months?. If the answer is 'no', the patient is eligible for the study. Exclusion Criteria: not having signed the informed consent.

Ages Eligible for Study
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Minimum Age: 45 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Research cluster 1: Antwerp<br>The first Dutch-speaking research cluster in a stepped wedge cluster design. Family doctors are implementing the Care Pathway for Primary Palliative Care and will recruit eligible patients from October 2014. | Other: Care Pathway for Primary Palliative Care<br>* Early identification of palliative care patients, anticipatory care planning, systematic symptom assessment, interdisciplinary collaboration, rigorous follow-up of the functional status of the patient and giving attention to the informal care givers.<br>* Other names: CPPPC;|
| Other: Research cluster 2: Mons<br>The first French-speaking research cluster in a stepped wedge cluster design. Family doctors are implementing the Care Pathway for Primary Palliative Care and will recruit eligible patients from November 2014. | Other: Care Pathway for Primary Palliative Care<br>* Early identification of palliative care patients, anticipatory care planning, systematic symptom assessment, interdisciplinary collaboration, rigorous follow-up of the functional status of the patient and giving attention to the informal care givers.<br>* Other names: CPPPC;|
| Other: Research cluster 3: Brussels<br>The only bilingual Dutch/French-speaking research cluster in a stepped wedge cluster design. Family doctors are implementing the Care Pathway for Primary Palliative Care and will recruit eligible patients from December 2014. | Other: Care Pathway for Primary Palliative Care<br>* Early identification of palliative care patients, anticipatory care planning, systematic symptom assessment, interdisciplinary collaboration, rigorous follow-up of the functional status of the patient and giving attention to the informal care givers.<br>* Other names: CPPPC;|
| Other: Research cluster 4: Limburg<br>The second Dutch-speaking research cluster in a stepped wedge cluster design. Family doctors will implement the Care Pathway for Primary Palliative Care and will recruit eligible patients from April 2015. | Other: Care Pathway for Primary Palliative Care<br>* Early identification of palliative care patients, anticipatory care planning, systematic symptom assessment, interdisciplinary collaboration, rigorous follow-up of the functional status of the patient and giving attention to the informal care givers.<br>* Other names: CPPPC;|
| Other: Research cluster 5: ?<br>A second French-speaking research cluster in a stepped wedge cluster design. Family doctors will implement the Care Pathway for Primary Palliative Care and will recruit eligible patients from October 2015. | Other: Care Pathway for Primary Palliative Care<br>* Early identification of palliative care patients, anticipatory care planning, systematic symptom assessment, interdisciplinary collaboration, rigorous follow-up of the functional status of the patient and giving attention to the informal care givers.<br>* Other names: CPPPC;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| percentage of deaths occurred in the hospital (of patients per family doctor/per research cluster) | The hypothesis is that the CPPPC reduces the percentage of deaths occurred in the hospital | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| cost of health care consumption in the last year of life (of patients per family doctor/per research cluster) | The hypothesis is that the CPPPC reduces the cost of health care consumption in the last year of life | 6 months | 
| consumption of antibiotics in the last year of life (of patients per family doctor/per research cluster) | The hypothesis is that the CPPPC reduces the consumption of antibiotics in the last year of life | 6 months | 
| consumption of pain killers in the last year of life (of patients per family doctor/per research cluster) | The hypothesis is that the CPPPC augments the consumption of pain killers in the last year of life | 6 months | 
| consumption of (invasive) diagnostic and therapeutic procedures in the last year of life (of patients per family doctor/per research cluster) | The hypothesis is that the CPPPC reduces the consumption of (invasive) diagnostic and therapeutic procedures in the last year of life | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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implementation, anticipatory care planning, symptom assessment, interdisciplinary collaboration