Prevalence and characteristics of patients with advanced chronic conditions in need of palliative care in the general population: a cross-sectional study

Gomez-Batiste, Xavier, Martinez-Munoz, Marisa, Blay, Carles, Amblas, Jordi, Vila, Laura, Costa, Xavier, Espaulella, Joan, Espinosa, Jose, Constante, Carles and Mitchell, Geoffrey K. (2014) Prevalence and characteristics of patients with advanced chronic conditions in need of palliative care in the general population: a cross-sectional study. Palliative Medicine, 28 4: 302-311. doi:10.1177/0269216313518266


Author Gomez-Batiste, Xavier
Martinez-Munoz, Marisa
Blay, Carles
Amblas, Jordi
Vila, Laura
Costa, Xavier
Espaulella, Joan
Espinosa, Jose
Constante, Carles
Mitchell, Geoffrey K.
Title Prevalence and characteristics of patients with advanced chronic conditions in need of palliative care in the general population: a cross-sectional study
Journal name Palliative Medicine   Check publisher's open access policy
ISSN 1477-030X
0269-2163
Publication date 2014-04-01
Year available 2014
Sub-type Article (original research)
DOI 10.1177/0269216313518266
Volume 28
Issue 4
Start page 302
End page 311
Total pages 10
Place of publication London, United Kingdom
Publisher SAGE Publications
Collection year 2015
Language eng
Formatted abstract
Background: Of deaths in high-income countries, 75% are caused by progressive advanced chronic conditions. Palliative care needs to be extended from terminal cancer to these patients. However, direct measurement of the prevalence of people in need of palliative care in the population has not been attempted.

Aim: Determine, by direct measurement, the prevalence of people in need of palliative care among advanced chronically ill patients in a whole geographic population.

Design: Cross-sectional, population-based study. Main outcome measure: prevalence of advanced chronically ill patients in need of palliative care according to the NECPAL CCOMS-ICO© tool. NECPAL+ patients were considered as in need of palliative care.

Setting/participants: County of Osona, Catalonia, Spain (156,807 inhabitants, 21.4% > 65 years). Three randomly selected primary care centres (51,595 inhabitants, 32.9% of County's population) and one district general hospital, one social-health centre and four nursing homes serving the patients. Subjects were all patients attending participating settings between November 2010 and October 2011.

Results: A total of 785 patients (1.5% of study population) were NECPAL+: mean age = 81.4 years; 61.4% female. Main disease/ condition: 31.3% advanced frailty, 23.4% dementia, 12.9% cancer (ratio of cancer/non-cancer = 1/7), 66.8% living at home and 19.7% in nursing home; only 15.5% previously identified as requiring palliative care; general clinical indicators of severity and progression present in 94% of cases.

Conclusions: Direct measurement of prevalence of palliative care needs on a population basis is feasible. Early identification and prevalence determination of these patients is likely to be the cornerstone of palliative care public health policies.
Keyword Palliative care
Chronic disease
Frail elderly
Prevalence
Health planning
Public health
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Medicine Publications
 
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