Effectiveness of the palliative care ‘Availability, Current issues and Anticipation’ (ACA) communication training programme for general practitioners on patient outcomes: A controlled trial

1. Willemjan Slort1
2. Annette H Blankenstein1
3. Bart PM Schweitzer1
4. Dirk L Knol2
5. Henriëtte E van der Horst1
6. Neil K Aaronson3
7. Luc Deliens4,5

1. ¹Department of General Practice and Elderly Care Medicine, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
2. ²Department of Epidemiology and Biostatistics, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
3. ³Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
4. ⁴Department of Public and Occupational Health, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
5. ⁵End-of-Life Care Research Group, Vrije Universiteit Brussel & Ghent University, Brussels, Belgium

1. Willemjan Slort, Department of General Practice and Elderly Care Medicine, EMGO + Institute for Health and Care Research, VU University Medical Center, Neerhofstraat 5, Amsterdam, 4761 BM Zevenbergen, The Netherlands. Email: slortentan@planet.nl; w.slort@vumc.nl

Abstract

Background: Although communicating effectively with patients receiving palliative care can be difficult, it may contribute to maintaining or enhancing patients’ quality of life. Little is known about the effect of training general practitioners in palliative care–specific communication. We hypothesized that palliative care patients of general practitioners exposed to the ‘Availability, Current issues and Anticipation’ communication training programme would report better outcomes than patients of control general practitioners.

Aim: To evaluate the effectiveness of the Availability, Current issues and Anticipation training programme for general practitioners on patient-reported outcomes.

Design: In a controlled trial, general practitioners followed the Availability, Current issues and Anticipation programme or were part of the control group. Patients receiving palliative care of participating general practitioners completed the Palliative Care Outcome Scale, the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative, the Rest & Peace Scale, the Patient Satisfaction Questionnaire–III and the Availability, Current issues and Anticipation Scale, at baseline and 12 months follow-up. We analysed differences between groups using linear mixed models. Trial registration: ISRCTN56722368. 

Setting/participants: General practitioners who attended a 2-year Palliative Care Training Course in the Netherlands.

Results: Questionnaire data were available for 145 patients (89 in intervention and 56 in control group). We found no significant differences over time between the intervention and control groups in any of the five outcome measures. Ceiling effects were observed for the Rest & Peace Scale, Patient Satisfaction Questionnaire–III and Availability, Current issues and Anticipation Scale. 

Conclusion: General practitioner participation in the Availability, Current issues and Anticipation training programme did not have a measurable effect on any of the outcomes investigated. Patients reported high levels of satisfaction with general practitioner care, regardless of group assignment. Future research might focus on general practitioners without special interest in palliative care.

• Communication
• controlled clinical trial
• education medical continuing
• family practice
• palliative care
• outcome assessment
• outcome measurement

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