Use of a structured palliative care summary in patients with established cancer is associated with reduced hospital admissions by out-of-hours general practitioners in Grampian

Asia Andeleeb Ali, Rosalind Adam, David Taylor, Peter Murchie

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Abstract

Objectives Palliative care summaries are
used by general practices to provide
structured anticipatory care information to
those providing care during the out-ofhours
period. We hypothesised that the
availability of a palliative care summary for
individuals with established cancer would
influence emergency hospital admission
during the out-of-hours period.
Methods Each consultation with Grampian
Medical Emergency Department (GMED) is
recorded on the ADASTRA software system
and the nature of the consultation is Read
coded.We retrospectively reviewed
consultations between 1 January 2011 and
31 December 2011 which had been coded as
‘neoplasm’ or ‘terminal care’. The availability
of a palliative care summary on ADASTRA
and admission status were recorded. χ2 Test
of association was performed. Binary logistic
regression was used for multivariate analysis
exploring the effect of a palliative care
summary on admission, while adjusting for
important confounders.
Results 401 patients with established cancer
were identified who had presented to
GMED in 2011. 35.7% had a palliative care
summary available on ADASTRA. Of the
401 contacts, 100 patients were admitted to
hospital. Not having a palliative care
summary made admission significantly more
likely; χ2=12.480, p=0.001. (OR 2.425,
95% CI 1.412 to 4.165).
Conclusions Availability of a structured
palliative care plan can aid decision making
in the out-of-hours period and prevent
unplanned hospital admissions.
Original languageEnglish
Pages (from-to)452-455
Number of pages4
JournalBMJ Supportive & Palliative Care
Volume3
Issue number4
Early online date3 Jan 2013
DOIs
Publication statusPublished - Dec 2013

Fingerprint

Palliative Care
General Practitioners
Referral and Consultation
Neoplasms
Terminal Care
Decision Support Techniques
General Practice
Hospital Emergency Service
Emergencies
Software

Cite this

@article{f7f4570eae524533ad390fe54d0b468b,
title = "Use of a structured palliative care summary in patients with established cancer is associated with reduced hospital admissions by out-of-hours general practitioners in Grampian",
abstract = "Objectives Palliative care summaries areused by general practices to providestructured anticipatory care information tothose providing care during the out-ofhoursperiod. We hypothesised that theavailability of a palliative care summary forindividuals with established cancer wouldinfluence emergency hospital admissionduring the out-of-hours period.Methods Each consultation with GrampianMedical Emergency Department (GMED) isrecorded on the ADASTRA software systemand the nature of the consultation is Readcoded.We retrospectively reviewedconsultations between 1 January 2011 and31 December 2011 which had been coded as‘neoplasm’ or ‘terminal care’. The availabilityof a palliative care summary on ADASTRAand admission status were recorded. χ2 Testof association was performed. Binary logisticregression was used for multivariate analysisexploring the effect of a palliative caresummary on admission, while adjusting forimportant confounders.Results 401 patients with established cancerwere identified who had presented toGMED in 2011. 35.7{\%} had a palliative caresummary available on ADASTRA. Of the401 contacts, 100 patients were admitted tohospital. Not having a palliative caresummary made admission significantly morelikely; χ2=12.480, p=0.001. (OR 2.425,95{\%} CI 1.412 to 4.165).Conclusions Availability of a structuredpalliative care plan can aid decision makingin the out-of-hours period and preventunplanned hospital admissions.",
author = "Ali, {Asia Andeleeb} and Rosalind Adam and David Taylor and Peter Murchie",
year = "2013",
month = "12",
doi = "10.1136/bmjspcare-2012-000371",
language = "English",
volume = "3",
pages = "452--455",
journal = "BMJ Supportive & Palliative Care",
issn = "2045-435X",
publisher = "BMJ Publishing Group",
number = "4",

}

TY - JOUR

T1 - Use of a structured palliative care summary in patients with established cancer is associated with reduced hospital admissions by out-of-hours general practitioners in Grampian

AU - Ali, Asia Andeleeb

AU - Adam, Rosalind

AU - Taylor, David

AU - Murchie, Peter

PY - 2013/12

Y1 - 2013/12

N2 - Objectives Palliative care summaries areused by general practices to providestructured anticipatory care information tothose providing care during the out-ofhoursperiod. We hypothesised that theavailability of a palliative care summary forindividuals with established cancer wouldinfluence emergency hospital admissionduring the out-of-hours period.Methods Each consultation with GrampianMedical Emergency Department (GMED) isrecorded on the ADASTRA software systemand the nature of the consultation is Readcoded.We retrospectively reviewedconsultations between 1 January 2011 and31 December 2011 which had been coded as‘neoplasm’ or ‘terminal care’. The availabilityof a palliative care summary on ADASTRAand admission status were recorded. χ2 Testof association was performed. Binary logisticregression was used for multivariate analysisexploring the effect of a palliative caresummary on admission, while adjusting forimportant confounders.Results 401 patients with established cancerwere identified who had presented toGMED in 2011. 35.7% had a palliative caresummary available on ADASTRA. Of the401 contacts, 100 patients were admitted tohospital. Not having a palliative caresummary made admission significantly morelikely; χ2=12.480, p=0.001. (OR 2.425,95% CI 1.412 to 4.165).Conclusions Availability of a structuredpalliative care plan can aid decision makingin the out-of-hours period and preventunplanned hospital admissions.

AB - Objectives Palliative care summaries areused by general practices to providestructured anticipatory care information tothose providing care during the out-ofhoursperiod. We hypothesised that theavailability of a palliative care summary forindividuals with established cancer wouldinfluence emergency hospital admissionduring the out-of-hours period.Methods Each consultation with GrampianMedical Emergency Department (GMED) isrecorded on the ADASTRA software systemand the nature of the consultation is Readcoded.We retrospectively reviewedconsultations between 1 January 2011 and31 December 2011 which had been coded as‘neoplasm’ or ‘terminal care’. The availabilityof a palliative care summary on ADASTRAand admission status were recorded. χ2 Testof association was performed. Binary logisticregression was used for multivariate analysisexploring the effect of a palliative caresummary on admission, while adjusting forimportant confounders.Results 401 patients with established cancerwere identified who had presented toGMED in 2011. 35.7% had a palliative caresummary available on ADASTRA. Of the401 contacts, 100 patients were admitted tohospital. Not having a palliative caresummary made admission significantly morelikely; χ2=12.480, p=0.001. (OR 2.425,95% CI 1.412 to 4.165).Conclusions Availability of a structuredpalliative care plan can aid decision makingin the out-of-hours period and preventunplanned hospital admissions.

U2 - 10.1136/bmjspcare-2012-000371

DO - 10.1136/bmjspcare-2012-000371

M3 - Article

VL - 3

SP - 452

EP - 455

JO - BMJ Supportive & Palliative Care

JF - BMJ Supportive & Palliative Care

SN - 2045-435X

IS - 4

ER -