Developing a computerised search to help UK General Practices identify more patients for palliative care planning: a feasibility study

Bruce Mason, Kirsty Boyd, Scott A Murray, John Steyn, Paul Comrie, Marilyn Kendall, Dan Munday, Peter Murchie, David Weller, Shirley Fife, Christine Campbell

Research output: Contribution to journalArticle

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Abstract

Background: Approximately 600,000 people die in the UK annually, usually after months or years of increasing debility. Many patients with advanced conditions are not identified for appropriate support before they die because they are not seen as having “palliative” care needs. General practice information
technology systems can improve care by identifying patients with deteriorating health so that their healthcare needs can be reviewed more systematically and effectively. The aim was to develop and test a computerised search of primary care records in routine clinical practice as a tool to improve patient identification for a palliative care approach.

Methods: An iterative process of search design and testing followed by implementation and extended testing of the search output in clinical practice. A three-phase feasibility study: developing a computerised search, determining its ability to identify patients with deteriorating health from any advanced condition, and assessing how primary care clinicians use the results to improve patient care. The setting was twelve primary
care teams in two Health Boards in Scotland.

Results: The search identified 0.6–1.7 % of patients in each practice who were not already on the palliative care register. Primary care clinicians judged that 30–60 % of these patients were at risk of dying or deterioration over the next 6–12 months. The most common action taken by GPs was to start an electronic
anticipatory care plan.

Conclusions: It is possible to significantly improve the identification of patients for palliative care needs assessment using a computerised search however barriers remain to GPs’ finding it acceptable. Time-efficient systems were important as was a generic tool for anticipatory care planning not linked to ‘palliative’ care.

Keywords: Primary healthcare, General practice, Palliative care, Qualitative research
Original languageEnglish
Article number99
Number of pages6
JournalBMC Family Practice
Volume16
DOIs
Publication statusPublished - 8 Aug 2015

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Patient Care Planning
Feasibility Studies
Palliative Care
General Practice
Primary Health Care
Patient Care
Health
Needs Assessment
Qualitative Research
Scotland
Delivery of Health Care

Keywords

  • Primary healthcare
  • General practice
  • Palliative care
  • Qualitative research

Cite this

Developing a computerised search to help UK General Practices identify more patients for palliative care planning : a feasibility study. / Mason, Bruce; Boyd, Kirsty; Murray, Scott A; Steyn, John; Comrie, Paul; Kendall, Marilyn; Munday, Dan; Murchie, Peter; Weller, David; Fife, Shirley; Campbell, Christine.

In: BMC Family Practice, Vol. 16, 99, 08.08.2015.

Research output: Contribution to journalArticle

Mason, Bruce ; Boyd, Kirsty ; Murray, Scott A ; Steyn, John ; Comrie, Paul ; Kendall, Marilyn ; Munday, Dan ; Murchie, Peter ; Weller, David ; Fife, Shirley ; Campbell, Christine. / Developing a computerised search to help UK General Practices identify more patients for palliative care planning : a feasibility study. In: BMC Family Practice. 2015 ; Vol. 16.
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abstract = "Background: Approximately 600,000 people die in the UK annually, usually after months or years of increasing debility. Many patients with advanced conditions are not identified for appropriate support before they die because they are not seen as having “palliative” care needs. General practice informationtechnology systems can improve care by identifying patients with deteriorating health so that their healthcare needs can be reviewed more systematically and effectively. The aim was to develop and test a computerised search of primary care records in routine clinical practice as a tool to improve patient identification for a palliative care approach. Methods: An iterative process of search design and testing followed by implementation and extended testing of the search output in clinical practice. A three-phase feasibility study: developing a computerised search, determining its ability to identify patients with deteriorating health from any advanced condition, and assessing how primary care clinicians use the results to improve patient care. The setting was twelve primarycare teams in two Health Boards in Scotland.Results: The search identified 0.6–1.7 {\%} of patients in each practice who were not already on the palliative care register. Primary care clinicians judged that 30–60 {\%} of these patients were at risk of dying or deterioration over the next 6–12 months. The most common action taken by GPs was to start an electronicanticipatory care plan. Conclusions: It is possible to significantly improve the identification of patients for palliative care needs assessment using a computerised search however barriers remain to GPs’ finding it acceptable. Time-efficient systems were important as was a generic tool for anticipatory care planning not linked to ‘palliative’ care. Keywords: Primary healthcare, General practice, Palliative care, Qualitative research",
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note = "We would like to thank all practices, patients and their carers who helped us successfully conduct this project. We are grateful for advice from Libby Morris, the eHealth Clinical Lead for NHS Scotland and a GP in Lothian. The project was funded by Marie Curie Cancer Care (ref A13575).",
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AU - Boyd, Kirsty

AU - Murray, Scott A

AU - Steyn, John

AU - Comrie, Paul

AU - Kendall, Marilyn

AU - Munday, Dan

AU - Murchie, Peter

AU - Weller, David

AU - Fife, Shirley

AU - Campbell, Christine

N1 - We would like to thank all practices, patients and their carers who helped us successfully conduct this project. We are grateful for advice from Libby Morris, the eHealth Clinical Lead for NHS Scotland and a GP in Lothian. The project was funded by Marie Curie Cancer Care (ref A13575).

PY - 2015/8/8

Y1 - 2015/8/8

N2 - Background: Approximately 600,000 people die in the UK annually, usually after months or years of increasing debility. Many patients with advanced conditions are not identified for appropriate support before they die because they are not seen as having “palliative” care needs. General practice informationtechnology systems can improve care by identifying patients with deteriorating health so that their healthcare needs can be reviewed more systematically and effectively. The aim was to develop and test a computerised search of primary care records in routine clinical practice as a tool to improve patient identification for a palliative care approach. Methods: An iterative process of search design and testing followed by implementation and extended testing of the search output in clinical practice. A three-phase feasibility study: developing a computerised search, determining its ability to identify patients with deteriorating health from any advanced condition, and assessing how primary care clinicians use the results to improve patient care. The setting was twelve primarycare teams in two Health Boards in Scotland.Results: The search identified 0.6–1.7 % of patients in each practice who were not already on the palliative care register. Primary care clinicians judged that 30–60 % of these patients were at risk of dying or deterioration over the next 6–12 months. The most common action taken by GPs was to start an electronicanticipatory care plan. Conclusions: It is possible to significantly improve the identification of patients for palliative care needs assessment using a computerised search however barriers remain to GPs’ finding it acceptable. Time-efficient systems were important as was a generic tool for anticipatory care planning not linked to ‘palliative’ care. Keywords: Primary healthcare, General practice, Palliative care, Qualitative research

AB - Background: Approximately 600,000 people die in the UK annually, usually after months or years of increasing debility. Many patients with advanced conditions are not identified for appropriate support before they die because they are not seen as having “palliative” care needs. General practice informationtechnology systems can improve care by identifying patients with deteriorating health so that their healthcare needs can be reviewed more systematically and effectively. The aim was to develop and test a computerised search of primary care records in routine clinical practice as a tool to improve patient identification for a palliative care approach. Methods: An iterative process of search design and testing followed by implementation and extended testing of the search output in clinical practice. A three-phase feasibility study: developing a computerised search, determining its ability to identify patients with deteriorating health from any advanced condition, and assessing how primary care clinicians use the results to improve patient care. The setting was twelve primarycare teams in two Health Boards in Scotland.Results: The search identified 0.6–1.7 % of patients in each practice who were not already on the palliative care register. Primary care clinicians judged that 30–60 % of these patients were at risk of dying or deterioration over the next 6–12 months. The most common action taken by GPs was to start an electronicanticipatory care plan. Conclusions: It is possible to significantly improve the identification of patients for palliative care needs assessment using a computerised search however barriers remain to GPs’ finding it acceptable. Time-efficient systems were important as was a generic tool for anticipatory care planning not linked to ‘palliative’ care. Keywords: Primary healthcare, General practice, Palliative care, Qualitative research

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KW - General practice

KW - Palliative care

KW - Qualitative research

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VL - 16

JO - BMC Family Practice

JF - BMC Family Practice

SN - 1471-2296

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ER -