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Early identification of and proactive palliative care for patients in general practice, incentive and methods of a randomized controlled trial

机译：一般实践中的患者的早期识别和积极姑息治疗，随机对照试验的激励和方法

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Background According to the Word Health Organization, patients who can benefit from palliative care should be identified earlier to enable proactive palliative care. Up to now, this is not common practice and has hardly been addressed in scientific literature. Still, palliative care is limited to the terminal phase and restricted to patients with cancer. Therefore, we trained general practitioners (GPs) in identifying palliative patients in an earlier phase of their disease trajectory and in delivering structured proactive palliative care. The aim of our study is to determine if this training, in combination with consulting an expert in palliative care regarding each palliative patient's tailored care plan, can improve different aspects of the quality of the remaining life of patients with severe chronic diseases such as chronic obstructive pulmonary disease, congestive heart failure and cancer. Methods/Design A two-armed randomized controlled trial was performed. As outcome variables we studied: place of death, number of hospital admissions and number of GP out of hours contacts. Discussion We expect that this study will increase the number of identified palliative care patients and improve different aspects of quality of palliative care. This is of importance to improve palliative care for patients with COPD, CHF and cancer and their informal caregivers, and to empower the GP. The study protocol is described and possible strengths and weaknesses and possible consequences have been outlined. Trial Registration The Netherlands National Trial Register: NTR2815
机译：背景技术根据卫生组织的单词，可以早先识别从姑息治疗中受益的患者，以实现积极的姑息治疗。到目前为止，这并不是常见的做法，并且在科学文学中几乎没有解决。虽然，姑息治疗仅限于终端阶段，并限于癌症患者。因此，我们培训了普通从业者（GPS）在疾病术的早期阶段识别姑息患者，并在提供结构化积极姑息治疗中。我们的研究目的是确定这项培训是否结合咨询了姑息治疗的姑息患者定制护理计划的专家，可以改善患者患者剩余寿命的不同方面，如慢性阻塞性的严重慢性疾病肺病，充血性心力衰竭和癌症。方法/设计进行双武装随机对照试验。作为我们研究的结果变量：死亡地点，医院录取数量和数小时的GP数量。讨论我们预计本研究将增加确定的姑息治疗患者的数量，并改善姑息治疗质量的不同方面。这对患有COPD，CHF和癌症和其非正式护理人员的患者改善姑息治疗并赋予GP的患者，这是重要的。描述了研究方案，并且已经概述了可能的强度和弱点以及可能的后果。审判登记荷兰国家试用登记册：NTR2815

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