BJGP open · 2026
Testing a structured end-of-life care approach in Danish general practice settings: a cohort study.
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Eriksen Matilde Alida Arendt, Melgaard Dorte, Søvsø Morten Breinholt, Thomsen Janus Laust, Jensen Morten Sig Ager, Krarup Anne Lund
Аннотация
BACKGROUND: The Acute Basic Palliation Concept (ABPC) - a structured end-of-life (EoL) care model - has shown increased quality of EoL care when used in hospital settings.
AIM: To measure if the use of the ABPC could increase symptom relief and user satisfaction when applied in general practice.
DESIGN & SETTING: This cohort study was conducted across nine general practices in Northern Denmark with 29 GPs, as well as 10 representatives from the regional out-of-hours GP service.
METHOD: GPs received training in an adapted ABPC and subsequently reported on patient cases managed both with and without the concept. Data on symptom control and satisfaction were collected via questionnaires from relatives, municipal caregivers, and GPs.
RESULTS: A total of 74 EoL care trajectories were included in the analysis, with 51% managed using the structured concept. The mean patient age was 84 ±8.9 years; 46% were female. The median duration from EoL care initiation to death was 3.0 (interquartile range 2.0-7.0) days. When using the concept, symptom control increased for pain (97% versus 83%), agitation (93% versus 56%), and discomfort (93% versus 81%; all P<0.05). Shortness of breath was less frequent, with a trend toward improved symptom relief using the concept (81% versus 54%). Most staff were willing to use the concept again (90% GPs and 100% municipal nurses).
CONCLUSION: The structured ABPC model facilitated adequate symptom management and was widely accepted among GPs and municipal nurses, demonstrating promising potential for EoL care in a general practice setting.
AIM: To measure if the use of the ABPC could increase symptom relief and user satisfaction when applied in general practice.
DESIGN & SETTING: This cohort study was conducted across nine general practices in Northern Denmark with 29 GPs, as well as 10 representatives from the regional out-of-hours GP service.
METHOD: GPs received training in an adapted ABPC and subsequently reported on patient cases managed both with and without the concept. Data on symptom control and satisfaction were collected via questionnaires from relatives, municipal caregivers, and GPs.
RESULTS: A total of 74 EoL care trajectories were included in the analysis, with 51% managed using the structured concept. The mean patient age was 84 ±8.9 years; 46% were female. The median duration from EoL care initiation to death was 3.0 (interquartile range 2.0-7.0) days. When using the concept, symptom control increased for pain (97% versus 83%), agitation (93% versus 56%), and discomfort (93% versus 81%; all P<0.05). Shortness of breath was less frequent, with a trend toward improved symptom relief using the concept (81% versus 54%). Most staff were willing to use the concept again (90% GPs and 100% municipal nurses).
CONCLUSION: The structured ABPC model facilitated adequate symptom management and was widely accepted among GPs and municipal nurses, demonstrating promising potential for EoL care in a general practice setting.