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Identifying patients with advanced chronic conditions for a progressive palliative care approach: a crosssectional study of prognostic indicators related to end-of-life trajectories

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dc.contributor Universitat de Vic - Universitat Central de Catalunya. Departament d'Economia i Empresa
dc.contributor Universitat de Vic - Universitat Central de Catalunya. Càtedra de Cures Pal·liatives
dc.contributor.author Amblàs-Novellas, Jordi
dc.contributor.author Murray, Scott A.
dc.contributor.author Espaulella Panicot, Joan
dc.contributor.author Martori, Joan Carles
dc.contributor.author Oller, Ramon
dc.contributor.author Martínez-Muñoz, Marisa
dc.contributor.author Molist Brunet, Núria
dc.contributor.author Blay, Carles
dc.contributor.author Gómez Batiste, Xavier
dc.date.accessioned 2017-06-29T16:55:31Z
dc.date.available 2017-06-29T16:55:31Z
dc.date.created 2016
dc.date.issued 2016
dc.identifier.citation Amblàs-Novellas, J., Murray,S.A, Espaulella,J, Martori,J.C, Oller,R, Martinez-Muñoz,M, Molist,N, Blay,C, Gómez-BatisteX.. (2016). Identifying patients with advanced chronic conditions for a progressive palliative care approach: a crosssectional study of prognostic indicators related to end-of-life trajectories. BMJ Open, 6(9), 1-10. es
dc.identifier.issn 2044-6055
dc.identifier.uri http://hdl.handle.net/10854/5038
dc.description.abstract Objectives: 2 innovative concepts have lately been developed to radically improve the care of patients with advanced chronic conditions (PACC): early identification of palliative care (PC) needs and the 3 end-of-life trajectories in chronic illnesses (acute, intermittent and gradual dwindling). It is not clear (1) what indicators work best for this early identification and (2) if specific clinical indicators exist for each of these trajectories. The objectives of this study are to explore these 2 issues. Setting: 3 primary care services, an acute care hospital, an intermediate care centre and 4 nursing homes in a mixed urban–rural district in Barcelona, Spain. Participants: 782 patients (61.5% women) with a positive NECPAL CCOMS-ICO test, indicating they might benefit from a PC approach. Outcome measures: The characteristics and distribution of the indicators of the NECPAL CCOMSICO tool are analysed with respect to the 3 trajectories and have been arranged by domain (functional, nutritional and cognitive status, emotional problems, geriatric syndromes, social vulnerability and others) and according to their static (severity) and dynamic (progression) properties. Results: The common indicators associated with early end-of-life identification are functional (44.3%) and nutritional (30.7%) progression, emotional distress (21.9%) and geriatric syndromes (15.7% delirium, 11.2% falls). The rest of the indicators showed differences in the associations per illness trajectories (p<0.05). 48.2% of the total cohort was identified as advanced frailty patients with no advanced disease criteria. Conclusions: Dynamic indicators are present in the 3 trajectories and are especially useful to identify PACC for a progressive PC approach purpose. Most of the other indicators are typically associated with a specific trajectory. These findings can help clinicians improve the identification of patients for a palliative approach. es
dc.format application/pdf
dc.format.extent 11 p. es
dc.language.iso eng es
dc.publisher BMJ Publishing es
dc.rights Aquest document està subjecte a aquesta llicència Creative Commons es
dc.rights.uri http://creativecommons.org/licenses/by-nc/4.0/ es
dc.subject.other Càncer -- Tractament pal·liatiu es
dc.subject.other Càncer -- Pacients es
dc.subject.other Tractament pal·liatiu es
dc.subject.other Malalts crònics es
dc.title Identifying patients with advanced chronic conditions for a progressive palliative care approach: a crosssectional study of prognostic indicators related to end-of-life trajectories es
dc.type info:eu-repo/semantics/article es
dc.identifier.doi https://doi.org/10.1136/bmjopen-2016-012340
dc.rights.accesRights info:eu-repo/semantics/openAccess es
dc.type.version info:eu-repo/publishedVersion es
dc.indexacio Indexat a WOS/JCR es

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