Differences in primary palliative care between people with organ failure and people with cancer: An international mortality follow-back study using quality indicators

Yolanda W. H. Penders, Bregje Onwuteaka-Philipsen, Sarah Moreels, G. A. Donker, Guido Miccinesi, Tomás Vega Alonso, Luc Deliens, Lieve van den Block

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Measuring the quality of palliative care in a systematic way using quality indicators can illuminate differences between patient groups. Aim: To investigate differences in the quality of palliative care in primary care between people who died of cancer and people who died of organ failure. Design: Mortality follow-back survey among general practitioners in Belgium, the Netherlands, and Spain (2013–2014), and Italy (2013–2015). A standardized registration form was used to construct quality indicators regarding regular pain measurement, acceptance of the approaching end of life, communication about disease-related topics with patient and next-of-kin; repeated multidisciplinary consultations; involvement of specialized palliative care; place of death; and bereavement counseling. Setting/participants: Patients (18+) who died non-suddenly of cancer, cardiovascular disease, or respiratory disease (n = 2360). Results: In all countries, people who died of cancer scored higher on the quality indicators than people who died of organ failure, particularly with regard to pain measurement (between 17 and 35 percentage-point difference in the different countries), the involvement of specialized palliative care (between 20 and 54 percentage points), and regular multidisciplinary meetings (between 12 and 24 percentage points). The differences between the patient groups varied by country, with Belgium showing most group differences (eight out of nine indicators) and Spain the fewest (two out of nine indicators). Conclusion: People who died of organ failure are at risk of receiving lower quality palliative care than people who died of cancer, but the differences vary per country. Initiatives to improve palliative care should have different priorities depending on the healthcare and cultural context.
Original languageEnglish
Pages (from-to)1498-1508
JournalPalliative Medicine
Volume32
Issue number9
DOIs
Publication statusPublished - 2018

Cite this

Penders, Yolanda W. H. ; Onwuteaka-Philipsen, Bregje ; Moreels, Sarah ; Donker, G. A. ; Miccinesi, Guido ; Alonso, Tomás Vega ; Deliens, Luc ; van den Block, Lieve. / Differences in primary palliative care between people with organ failure and people with cancer: An international mortality follow-back study using quality indicators. In: Palliative Medicine. 2018 ; Vol. 32, No. 9. pp. 1498-1508.
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abstract = "Background: Measuring the quality of palliative care in a systematic way using quality indicators can illuminate differences between patient groups. Aim: To investigate differences in the quality of palliative care in primary care between people who died of cancer and people who died of organ failure. Design: Mortality follow-back survey among general practitioners in Belgium, the Netherlands, and Spain (2013–2014), and Italy (2013–2015). A standardized registration form was used to construct quality indicators regarding regular pain measurement, acceptance of the approaching end of life, communication about disease-related topics with patient and next-of-kin; repeated multidisciplinary consultations; involvement of specialized palliative care; place of death; and bereavement counseling. Setting/participants: Patients (18+) who died non-suddenly of cancer, cardiovascular disease, or respiratory disease (n = 2360). Results: In all countries, people who died of cancer scored higher on the quality indicators than people who died of organ failure, particularly with regard to pain measurement (between 17 and 35 percentage-point difference in the different countries), the involvement of specialized palliative care (between 20 and 54 percentage points), and regular multidisciplinary meetings (between 12 and 24 percentage points). The differences between the patient groups varied by country, with Belgium showing most group differences (eight out of nine indicators) and Spain the fewest (two out of nine indicators). Conclusion: People who died of organ failure are at risk of receiving lower quality palliative care than people who died of cancer, but the differences vary per country. Initiatives to improve palliative care should have different priorities depending on the healthcare and cultural context.",
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Differences in primary palliative care between people with organ failure and people with cancer: An international mortality follow-back study using quality indicators. / Penders, Yolanda W. H.; Onwuteaka-Philipsen, Bregje; Moreels, Sarah; Donker, G. A.; Miccinesi, Guido; Alonso, Tomás Vega; Deliens, Luc; van den Block, Lieve.

In: Palliative Medicine, Vol. 32, No. 9, 2018, p. 1498-1508.

Research output: Contribution to journalArticleAcademicpeer-review

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T1 - Differences in primary palliative care between people with organ failure and people with cancer: An international mortality follow-back study using quality indicators

AU - Penders, Yolanda W. H.

AU - Onwuteaka-Philipsen, Bregje

AU - Moreels, Sarah

AU - Donker, G. A.

AU - Miccinesi, Guido

AU - Alonso, Tomás Vega

AU - Deliens, Luc

AU - van den Block, Lieve

PY - 2018

Y1 - 2018

N2 - Background: Measuring the quality of palliative care in a systematic way using quality indicators can illuminate differences between patient groups. Aim: To investigate differences in the quality of palliative care in primary care between people who died of cancer and people who died of organ failure. Design: Mortality follow-back survey among general practitioners in Belgium, the Netherlands, and Spain (2013–2014), and Italy (2013–2015). A standardized registration form was used to construct quality indicators regarding regular pain measurement, acceptance of the approaching end of life, communication about disease-related topics with patient and next-of-kin; repeated multidisciplinary consultations; involvement of specialized palliative care; place of death; and bereavement counseling. Setting/participants: Patients (18+) who died non-suddenly of cancer, cardiovascular disease, or respiratory disease (n = 2360). Results: In all countries, people who died of cancer scored higher on the quality indicators than people who died of organ failure, particularly with regard to pain measurement (between 17 and 35 percentage-point difference in the different countries), the involvement of specialized palliative care (between 20 and 54 percentage points), and regular multidisciplinary meetings (between 12 and 24 percentage points). The differences between the patient groups varied by country, with Belgium showing most group differences (eight out of nine indicators) and Spain the fewest (two out of nine indicators). Conclusion: People who died of organ failure are at risk of receiving lower quality palliative care than people who died of cancer, but the differences vary per country. Initiatives to improve palliative care should have different priorities depending on the healthcare and cultural context.

AB - Background: Measuring the quality of palliative care in a systematic way using quality indicators can illuminate differences between patient groups. Aim: To investigate differences in the quality of palliative care in primary care between people who died of cancer and people who died of organ failure. Design: Mortality follow-back survey among general practitioners in Belgium, the Netherlands, and Spain (2013–2014), and Italy (2013–2015). A standardized registration form was used to construct quality indicators regarding regular pain measurement, acceptance of the approaching end of life, communication about disease-related topics with patient and next-of-kin; repeated multidisciplinary consultations; involvement of specialized palliative care; place of death; and bereavement counseling. Setting/participants: Patients (18+) who died non-suddenly of cancer, cardiovascular disease, or respiratory disease (n = 2360). Results: In all countries, people who died of cancer scored higher on the quality indicators than people who died of organ failure, particularly with regard to pain measurement (between 17 and 35 percentage-point difference in the different countries), the involvement of specialized palliative care (between 20 and 54 percentage points), and regular multidisciplinary meetings (between 12 and 24 percentage points). The differences between the patient groups varied by country, with Belgium showing most group differences (eight out of nine indicators) and Spain the fewest (two out of nine indicators). Conclusion: People who died of organ failure are at risk of receiving lower quality palliative care than people who died of cancer, but the differences vary per country. Initiatives to improve palliative care should have different priorities depending on the healthcare and cultural context.

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