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Being identified for palliative care provided in the community by primary care teams (PCTs) leads to an increased likelihood that the recipient's wishes around place of care and treatment objectives will be met, and that the recipient is likely to have fewer emergency admissions and spend less time in hospital during their last year of life [ 1, 3].
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Most patients are not identified for a palliative care approach before they die [ 6] because they are not identified as having 'palliative' care needs [ 7, 8].
How can non-cancer patients be best identified for supportive and palliative care in the community?
Research in 2012 [ 4] found that many patients were not being identified for inclusion on the GP palliative care register before death, or if they were identified they were identified very late in the illness trajectory [ 5].
This study describes these barriers at Bugando Medical Center, one of three consultant hospitals in Tanzania, to identify areas for palliative care development suitable to this context.
Further details are available from the authors.> Patients who were already on the practice palliative care register or who had previously been identified with a palliative care code (for example, people currently receiving palliative oncology treatment) were excluded because they were presumed to have already been identified as candidates for palliative care.
A tool, consisting of eight indicators, was designed to explain and promote the palliative activity in a hospital, including the partnership between the palliative mobile care team and services identified with beds for palliative care.
Gaps in data collection were identified - particularly for palliative care and patient-reported outcomes.
GPs reported differences in how they identified a need for palliative care in cancer patients versus those with other diseases.
The characteristics of the following two groups were compared to the remaining patients with a clinical CHF diagnosis: a) those identified as appropriate for palliative care irrespective of ECHO data, and b) those with ejection fraction ≤45% and palliative care appropriate.
This study was part of a larger EOL care surveillance network project that focused on health service use in the last year of life for identified palliative patients with advanced illness [ 11].
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