Computer screening for palliative care needs in primary care: a mixed-methods study.

Area of Science:

• Primary Care
• Palliative Care
• Health Informatics

Background:

• Most individuals, especially those with multimorbidity and frailty, could benefit from palliative care but do not receive it.
• General Practitioners (GPs) face challenges in identifying suitable patients for palliative care.

Purpose of the Study:

• To refine and evaluate a computer application, AnticiPal, designed to assist primary care teams in screening patients.
• The application aims to identify individuals who would benefit from palliative care.

Main Methods:

• A mixed-methods study was conducted across eight GP practices in Scotland between 2016 and 2017.
• The approach involved a computer search development cycle, analysis of identified patients, qualitative observations of the tool's use, and interviews with healthcare professionals and patients.

Main Results:

• The computer search identified 0.8% of 62,708 registered patients.
• GPs recognized the tool's utility in identifying unrecognized patients with advanced multimorbidity and frailty but expressed concerns about workload.
• Patients and carers valued the proactive identification of individuals with advanced illnesses.

Conclusions:

• Computer searching can aid GP practices in generating patient lists for review and care planning.
• Key palliative care components, like proactive planning and information sharing, are valued by patients.
• Screening for deteriorating health should be a quality improvement focus, not solely limited to 'palliative care'.