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首页> 外文期刊>BMC Family Practice >Developing a computerised search to help UK General Practices identify more patients for palliative care planning: a feasibility study
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Developing a computerised search to help UK General Practices identify more patients for palliative care planning: a feasibility study

机译：进行计算机搜索以帮助UK General Practices确定更多患者进行姑息治疗计划：一项可行性研究

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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.
机译：背景信息英国每年约有60万人死亡，通常是在数月或数年的残障率增加之后。许多病情恶化的患者在死亡之前并未得到适当的支持，因为他们没有被视为具有“姑息”护理需求。全科医学信息技术系统可以通过识别健康状况恶化的患者来改善护理，从而可以更系统，更有效地审查他们的医疗保健需求。目的是在常规临床实践中开发和测试对初级保健记录的计算机搜索，以此作为改善姑息治疗方法患者识别的工具。方法搜索设计和测试的迭代过程，然后在临床实践中对搜索输出进行实施和扩展测试。可行性研究分为三个阶段：进行计算机搜索，确定其从任何晚期疾病中识别出健康状况恶化的患者的能力，并评估初级保健临床医生如何使用这些结果来改善患者的护理。背景是苏格兰两个卫生局的十二个初级保健团队。结果搜索确定了每种实践中尚未纳入姑息治疗登记册的患者中有0.6–1.7％的患者。初级保健临床医生认为，这些患者中有30-60％在接下来的6-12个月内有死亡或恶化的风险。全科医生采取的最常见的措施是启动电子预期护理计划。结论可以通过计算机搜索显着改善对姑息治疗需求评估的患者识别，但是对于全科医生来说，接受它仍然存在障碍。节省时间的系统非常重要，这是与“姑息”护理无关的预期性照护计划的通用工具。

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