Assessment of Palliative Care Needs in Non-oncological Patients in Primary Health Care: A Cross-Sectional Study

Introduction Patients with non-oncological chronic illnesses often have significant palliative care needs (PCN), which frequently go unrecognized due to the unpredictable course of these diseases. Early identification tools can facilitate the detection of PCN within primary health care (PHC). This study aimed to assess PCN among patients with stroke, chronic obstructive pulmonary disease, heart failure, and dementia in four primary care units (PCUs) of the Braga Local Health Unit (ULS Braga); to compare the Surprise Question (SQ) with the Portuguese version of the Supportive and Palliative Care Indicators Tool (SPICT-PT™); to evaluate the level of agreement between family physicians (FPs) and family nurses (FNs); and to characterize referrals to palliative care (PC) units. Materials and methods A cross-sectional observational study was conducted, including 327 chronic patients from four PCUs of ULS Braga. Both FPs and FNs applied the SQ and the SPICT-PT™ to assess each patient's PCN. Results PCN were identified in 44.0% of patients using the SQ and in 38.2% using the SPICT-PT™, with a statistically significant correlation between the tools (p < 0.001). Dementia showed the strongest association with PCN. There was moderate agreement between FPs and FNs for both tools, with FPs reporting greater confidence in using the SPICT-PT™. Despite the identification of needs, only 12.5% (SQ) and 14.4% (SPICT-PT™) of patients were referred to PC units. Conclusions Non-oncological chronic patients, particularly those with dementia, often have unmet PCN. Routine use of structured tools can enhance early identification, support multidisciplinary evaluation, and highlight the need for better integration of PC into PHC.