Adding a second surprise question triggers general practitioners to increase the thoroughness of palliative care planning: results of a pilot RCT with cage vignettes

摘要

BackgroundIn our aging society, palliative care should be a standard component of health care. However, currently it is only provided to a small proportion of patients, mostly to those with cancer, and restricted to the terminal phase. Many general practitioners (GPs) say that one of their most significant challenges is to assess the right moment to start anticipatory palliative care. The “Surprise Question” (SQ1: “Would I be surprised if this patient were to die in the next 12 months”?), if answered with “no”, is an easy tool to apply in identifying patients in need of palliative care. However, this tool has a low specificity. Therefore, the aim of our pilot study was to determine if adding a second, more specific “Surprise Question” (SQ2: “Would I be surprised if this patient is still alive after 12 months”?) in case SQ1 is answered in the negative, prompts GPs to plan for anticipatory palliative care.