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Variation in the implementation of PaTz: a method to improve palliative care in general practice - a prospective observational study
BACKGROUND: PaTz (palliative care at home) is a method to improve palliative care in the primary care setting in the Netherlands. PaTz has three basic principles: (1) local GPs and DNs meet at least six times per year to identify and discuss their patients with a life-threatening illness; (2) these...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6966787/ https://www.ncbi.nlm.nih.gov/pubmed/31948417 http://dx.doi.org/10.1186/s12904-020-0514-6 |
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author | Koper, Ian Pasman, H. Roeline W. Schweitzer, Bart P. M. van der Zweep, Greet Uyttewaal, Gon Onwuteaka-Philipsen, Bregje D. |
author_facet | Koper, Ian Pasman, H. Roeline W. Schweitzer, Bart P. M. van der Zweep, Greet Uyttewaal, Gon Onwuteaka-Philipsen, Bregje D. |
author_sort | Koper, Ian |
collection | PubMed |
description | BACKGROUND: PaTz (palliative care at home) is a method to improve palliative care in the primary care setting in the Netherlands. PaTz has three basic principles: (1) local GPs and DNs meet at least six times per year to identify and discuss their patients with a life-threatening illness; (2) these meetings are supervised by a specialist palliative care professional; (3) groups use a palliative care register on which all identified patients are listed. Since the start in 2010, the number of PaTz-groups in the Netherlands has been growing consistently. Although the theory of all PaTz-groups is the same, the practical functioning of PaTz-groups may vary substantially, which may complicate further implementation of PaTz as well as interpretation of effect studies. This study aims to describe the variation in practice of PaTz-groups in the Netherlands. METHOD: In this prospective observational study, ten PaTz-groups logged and described the activities in their meetings as well as the registered and discussed patients and topics of discussions in registration forms for a 1 year follow-up period. In addition, non-participatory observations were performed in all participating groups. Meeting and patient characteristics were analysed using descriptive statistics. Conventional content analysis was performed in the analysis of topic discussions. RESULTS: While the basic principles of PaTz are found in almost every PaTz-group, there is considerable variation in the practice and content of the meetings of different PaTz-groups. Most groups spend little time on other topics than their patients, although the number of patients discussed in a single meeting varies considerably, as well as the time spent on an individual patient. Most registered patients were diagnosed with cancer and patient discussions mainly concerned current affairs and rarely concerned future issues. CONCLUSION: The basic principles are the cornerstone of any PaTz-group. At the same time, the observed variation between PaTz-groups indicates that tailoring a PaTz-group to the needs of its participants is important and may enhance its sustainability. The flexibility of PaTz-groups may also provide opportunity to modify the content and tools used, and improve identification of palliative patients and advance care planning. |
format | Online Article Text |
id | pubmed-6966787 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-69667872020-01-22 Variation in the implementation of PaTz: a method to improve palliative care in general practice - a prospective observational study Koper, Ian Pasman, H. Roeline W. Schweitzer, Bart P. M. van der Zweep, Greet Uyttewaal, Gon Onwuteaka-Philipsen, Bregje D. BMC Palliat Care Research Article BACKGROUND: PaTz (palliative care at home) is a method to improve palliative care in the primary care setting in the Netherlands. PaTz has three basic principles: (1) local GPs and DNs meet at least six times per year to identify and discuss their patients with a life-threatening illness; (2) these meetings are supervised by a specialist palliative care professional; (3) groups use a palliative care register on which all identified patients are listed. Since the start in 2010, the number of PaTz-groups in the Netherlands has been growing consistently. Although the theory of all PaTz-groups is the same, the practical functioning of PaTz-groups may vary substantially, which may complicate further implementation of PaTz as well as interpretation of effect studies. This study aims to describe the variation in practice of PaTz-groups in the Netherlands. METHOD: In this prospective observational study, ten PaTz-groups logged and described the activities in their meetings as well as the registered and discussed patients and topics of discussions in registration forms for a 1 year follow-up period. In addition, non-participatory observations were performed in all participating groups. Meeting and patient characteristics were analysed using descriptive statistics. Conventional content analysis was performed in the analysis of topic discussions. RESULTS: While the basic principles of PaTz are found in almost every PaTz-group, there is considerable variation in the practice and content of the meetings of different PaTz-groups. Most groups spend little time on other topics than their patients, although the number of patients discussed in a single meeting varies considerably, as well as the time spent on an individual patient. Most registered patients were diagnosed with cancer and patient discussions mainly concerned current affairs and rarely concerned future issues. CONCLUSION: The basic principles are the cornerstone of any PaTz-group. At the same time, the observed variation between PaTz-groups indicates that tailoring a PaTz-group to the needs of its participants is important and may enhance its sustainability. The flexibility of PaTz-groups may also provide opportunity to modify the content and tools used, and improve identification of palliative patients and advance care planning. BioMed Central 2020-01-16 /pmc/articles/PMC6966787/ /pubmed/31948417 http://dx.doi.org/10.1186/s12904-020-0514-6 Text en © The Author(s). 2020 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Koper, Ian Pasman, H. Roeline W. Schweitzer, Bart P. M. van der Zweep, Greet Uyttewaal, Gon Onwuteaka-Philipsen, Bregje D. Variation in the implementation of PaTz: a method to improve palliative care in general practice - a prospective observational study |
title | Variation in the implementation of PaTz: a method to improve palliative care in general practice - a prospective observational study |
title_full | Variation in the implementation of PaTz: a method to improve palliative care in general practice - a prospective observational study |
title_fullStr | Variation in the implementation of PaTz: a method to improve palliative care in general practice - a prospective observational study |
title_full_unstemmed | Variation in the implementation of PaTz: a method to improve palliative care in general practice - a prospective observational study |
title_short | Variation in the implementation of PaTz: a method to improve palliative care in general practice - a prospective observational study |
title_sort | variation in the implementation of patz: a method to improve palliative care in general practice - a prospective observational study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6966787/ https://www.ncbi.nlm.nih.gov/pubmed/31948417 http://dx.doi.org/10.1186/s12904-020-0514-6 |
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