Palliative Care in General Practice - Concordance of Care Assessment Between General Practitioners and Patients on the Palliative Care Outcome Scale (POS)

摘要

Background To observe and tailor care to the individual situation of palliative patients in home care is an important factor of quality of care (QoC) and a crucial patient-relevant outcome. Aim An observational study analysed if there is an increased concordance between patients and general practitioners (GPs) with vocational training in palliative care compared to GPs without this training. Methods GPs who participated in the vocational training courses of the Palliativmedizinische Initiative Nordbaden (PAMINO) and GPs of a control group (CG) and palliative patients they cared for assessed the QoC in the 3 prior days on the Palliative Care Outcome Scale (POS) within the last month of life or at the end of a 6-month observation period. Results 65 patients of 29 GPs in the PAMINO group (PG) assessed QoC with a mean of 12.6 points (SD=6.3), 35 patients of 19 GPs in the CG with a mean of 12.1 points (SD = 7.0) (p=0.80). GPs in the PG overestimated QoC compared to their patients (mean difference 2.5 points); in the CG, patients and GPs agreed (mean difference 0.4 points). Patients primarily reported of the worries of their family, while GPs primarily reported a limitation in general health. Conclusion A vocational training did not increase concordance in the assessment of QoC between patients and GPs. Worries of patients and their family caregivers are not enough recognized, so palliative care should improve further.