Scripties UMCG - Rijksuniversiteit Groningen
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Palliative Active Care Team (PACT) Studie : “Opnamereductie door middel van consultvoering”

(2019) Dekker, N.R.P.

Background: Advance Care Planning (ACP) is a way of consultation within the palliative care to increase the quality of life of patients by formulating a proactive care plan. It is currently unclear what the effects of ACP are for outpatients in the Dutch healthcare system.
Aim: This pilot investigated if early ACP for outpatients in the Netherlands is feasible, if ACP results in a reduction of days of hospitalizations, an increase in the quality of life and a high satisfaction rate of patients and general practitioners.
Methods: 24 palliative outpatients with an incurable upper gastrointestinal tract malignancy with a life expectancy of less than a year were randomized in a group which received the standard oncology care and a group which in addition received a consultation executed by a specialized palliative team. Primary endpoint was the total number of unplanned days of hospitalization after three months. Additionally, the quality of life, experienced burden of primary caregivers and satisfaction of patients and general practitioners were measured. Results: At the start there were no significant differences between both groups. After three months eight patients of both groups were alive. There was no significant change in total number of unplanned days of hospitalization and quality of life. All questioned patients stated to experience ACP as positive and 90% of the general practitioners stated to be open for advice in the palliative phase.
Conclusion: ACP for outpatients is feasible in the Dutch healthcare system with a high satisfaction rate of patients and high openness of general practitioners. ACP for outpatients seems to have no difference in the number of unplanned days of hospitalization within this study design. There is a strong indication it can benefit in the quality of life.

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