Physician factors associated with outpatient palliative care referral.

Abstract:

:Outpatient palliative care can provide significant benefits to seriously ill patients, but several barriers to appropriate referrals remain. No study has examined the physician factors associated with referral to outpatient palliative care. To determine physician factors, with a focus on physician beliefs, associated with referral to palliative care. Cross-sectional study of 170 primary care physicians at Kaiser Permanente (KP), a large non-profit Health Maintenance Organisation (HMO), using a self-administered questionnaire. Of the 145 respondents, 100 (70%) reported referring any patients to the palliative care program in the prior year, with a median of 3 referrals (interquartile range 2, 6). Factors associated with referral included working at KP between 10 and 20 years as compared to <10 years [Odds ratio [OR] 6.29 (95% confidence interval [CI] 1.38, 28.6)] and having personal experience with palliative care [OR 2.13 (95% CI 0.95, 4.976)]. None of the beliefs scales was associated with referral. Physician characteristics other than their beliefs about palliative care played a significant role in determining referral. Palliative care programs should aim to increase their visibility in the outpatient setting to increase referrals by primary care physicians. Tools that help physicians identify seriously ill patients who could benefit from palliative care may also serve to increase appropriate referrals.

journal_name

Palliat Med

journal_title

Palliative medicine

authors

Ahluwalia SC,Fried TR

doi

10.1177/0269216309106315

subject

Has Abstract

pub_date

2009-10-01 00:00:00

pages

608-15

issue

7

eissn

0269-2163

issn

1477-030X

pii

0269216309106315

journal_volume

23

pub_type

杂志文章,多中心研究
  • A cross-national cross-sectional survey of the attitudes and perceived competence of final-year medicine, nursing and pharmacy students in relation to end-of-life care in dementia.

    abstract:BACKGROUND:Little is known about the attitudes of healthcare professional students' perceived competence and confidence in treating those with dementia who are at the end of life. AIM:To explore the attitudes of final year medical, nursing and pharmacy students towards people with dementia and to evaluate their percei...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1177/0269216313483661

    authors: De Witt Jansen B,Weckmann M,Nguyen CM,Parsons C,Hughes CM

    更新日期:2013-10-01 00:00:00

  • Comparison of preferences for end-of-life care among patients with advanced cancer and their caregivers: A discrete choice experiment.

    abstract:BACKGROUND:Patients with advanced cancer often have to make difficult decisions, such as how much to spend on moderately life-extending treatments. This and other end-of-life decisions are also influenced by their informal caregivers. Understanding the relative value that patients and their caregivers place on various ...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1177/0269216315578803

    authors: Malhotra C,Farooqui MA,Kanesvaran R,Bilger M,Finkelstein E

    更新日期:2015-10-01 00:00:00

  • A study comparing hyoscine hydrobromide and glycopyrrolate in the treatment of death rattle.

    abstract::This study looked at the efficacy of drug treatment in managing death rattle in a 30-bedded specialist palliative care unit. The study was conducted in two phases. In the first, patients received hyoscine hydrobromide as the antimuscarinic; glycopyrrolate was used in the second phase. The patients in the two phases we...

    journal_title:Palliative medicine

    pub_type: 临床试验,杂志文章

    doi:10.1191/026921601678320313

    authors: Back IN,Jenkins K,Blower A,Beckhelling J

    更新日期:2001-07-01 00:00:00

  • The Liverpool Care Pathway for cancer patients dying in hospital medical wards: a before-after cluster phase II trial of outcomes reported by family members.

    abstract:BACKGROUND:Hospital is the most common place of cancer death but concerns regarding the quality of end-of-life care remain. AIM:Preliminary assessment of the effectiveness of the Liverpool Care Pathway on the quality of end-of-life care provided to adult cancer patients during their last week of life in hospital. DES...

    journal_title:Palliative medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1177/0269216313487569

    authors: Costantini M,Pellegrini F,Di Leo S,Beccaro M,Rossi C,Flego G,Romoli V,Giannotti M,Morone P,Ivaldi GP,Cavallo L,Fusco F,Higginson IJ

    更新日期:2014-01-01 00:00:00

  • Good end-of-life care in nursing home according to the family carers' perspective: A systematic review of qualitative findings.

    abstract:BACKGROUND:Nursing homes are becoming a common site where delivering end-of-life care for older adults. They often represent the junction between the curative and the palliative phase. AIM:To identify the elements that nursing home residents' family carers perceive as good end-of-life care and develop a conceptual mod...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1177/0269216319840275

    authors: Gonella S,Basso I,De Marinis MG,Campagna S,Di Giulio P

    更新日期:2019-06-01 00:00:00

  • Does being religious help or hinder coping with chronic illness? A critical literature review.

    abstract::This paper reviews a number of studies relating to religion and coping with chronic illness, emphasizing those aspects relevant to palliative care. After pointing out that religious and existential needs are common in chronic illness, a critical examination is made of those studies which purport to demonstrate associa...

    journal_title:Palliative medicine

    pub_type: 杂志文章,评审

    doi:10.1177/026921639701100405

    authors: Dein S,Stygall J

    更新日期:1997-07-01 00:00:00

  • A review of dysphagia in four cases of motor neurone disease.

    abstract::Dysphagia is a common and distressing problem in motor neurone disease. This paper examines some of the strategies available for managing patients with dysphagia, and illustrates these with four contrasting case histories. The factors which influence the decision making process in patients with dysphagia are also disc...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1177/0269216393007004S08

    authors: Scott A,Heughan A

    更新日期:1993-01-01 00:00:00

  • The Nordic Specialist Course in Palliative Medicine: evaluation and experiences from the first course 2003-2005.

    abstract:BACKGROUND AND AIMS:Palliative medicine is not recognized as a medical specialty in any of the five Nordic countries, but there is a great need for physicians with specialty qualifications to serve on an increasing number of palliative care services. The Associations for Palliative Medicine in the five countries agreed...

    journal_title:Palliative medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1177/0269216307087320

    authors: Haugen DF,Vejlgaard T

    更新日期:2008-04-01 00:00:00

  • Benzonatate for opioid-resistant cough in advanced cancer.

    abstract::Chronic cough is a distressing symptom experienced by approximately 37% of patients with advanced cancer. Palliation of chronic nonproductive cough should always first address the underlying cause but in some patients chronic, nonproductive cough persists and antitussive agents are required. Opioids are the gold stand...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1191/026921698672930910

    authors: Doona M,Walsh D

    更新日期:1998-01-01 00:00:00

  • Services given and help perceived during home care for terminal cancer.

    abstract::Separate accounts of care were recorded weekly from staff, patients and relatives in a randomised sample of patients with terminal cancer referred to a home care service with readily available beds. Various services were involved but nurses made most contacts, 3.0 visits and 2.4 phone calls weekly, rising sharply in t...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1177/026921639601000207

    authors: Hinton J

    更新日期:1996-04-01 00:00:00

  • Retrospective evaluation of palliative care and hospice utilization in hospitalized patients with metastatic breast cancer.

    abstract:BACKGROUND:Hospitalizations in patients with metastatic cancer occur commonly at the end of life but have not been well-described in individuals with metastatic breast cancer. AIM:To describe the reasons for admission and frequency of palliative care and hospice utilization in hospitalized patients with metastatic bre...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1177/0269216316637238

    authors: Shin JA,Parkes A,El-Jawahri A,Traeger L,Knight H,Gallagher ER,Temel JS

    更新日期:2016-10-01 00:00:00

  • Spinal surgery in the treatment of metastatic back pain: three case reports.

    abstract::Back pain resulting from spinal instability in metastatic bone disease can be difficult to alleviate by pharmacological methods and surgical intervention is frequently required. This paper discusses the treatment options with three illustrative case reports. ...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1177/026921639300700311

    authors: Fallon MT,O'Neill WM

    更新日期:1993-01-01 00:00:00

  • A patient with dementia and cancer: to feed via percutaneous endoscopic gastrostomy tube or not?

    abstract::Despite the lack of clear benefits of feeding via gastrostomy tube in dementia patients, its use has been increasing. The views of health professionals, patients and their carers differ widely about the perceived benefits, which makes decision-making difficult and stressful. The palliative care approach of facilitatin...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1177/0269216306071796

    authors: Shah SH

    更新日期:2006-10-01 00:00:00

  • Attitudes and beliefs of palliative care physicians regarding communication with terminally ill cancer patients.

    abstract::The subject of communication between palliative care physicians and their patients regarding their diagnosis and prognosis has not been extensively researched. The purpose of this survey was to compare the attitudes and beliefs of palliative care specialists regarding communication with the terminally ill in Europe, S...

    journal_title:Palliative medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1191/026921600674582192

    authors: Bruera E,Neumann CM,Mazzocato C,Stiefel F,Sala R

    更新日期:2000-07-01 00:00:00

  • Information disclosure to terminally ill patients and their relatives: self-reported practice of Belgian clinical specialists and general practitioners.

    abstract::Objective of this study is to examine physicians' practices regarding information disclosure to terminally ill patients and to their relatives, without informing the patient. A questionnaire had been sent to a random sample of 3014 Belgian physicians from different specialties frequently involved in end-of-life care. ...

    journal_title:Palliative medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1177/0269216308102043

    authors: Michiels E,Deschepper R,Bilsen J,Mortier F,Deliens L

    更新日期:2009-06-01 00:00:00

  • The challenges of uncertainty and interprofessional collaboration in palliative care for non-cancer patients in the community: a systematic review of views from patients, carers and health-care professionals.

    abstract:BACKGROUND:Primary care has the potential to play significant roles in providing effective palliative care for non-cancer patients. AIM:To identify, critically appraise and synthesise the existing evidence on views on the provision of palliative care for non-cancer patients by primary care providers and reveal any gap...

    journal_title:Palliative medicine

    pub_type: 杂志文章,评审

    doi:10.1177/0269216314531999

    authors: Oishi A,Murtagh FE

    更新日期:2014-10-01 00:00:00

  • Current status of accurate prognostic awareness in advanced/terminally ill cancer patients: Systematic review and meta-regression analysis.

    abstract:BACKGROUND:No systematic meta-analysis is available on the prevalence of cancer patients' accurate prognostic awareness and differences in accurate prognostic awareness by publication year, region, assessment method, and service received. AIM:To examine the prevalence of advanced/terminal cancer patients' accurate pro...

    journal_title:Palliative medicine

    pub_type: 杂志文章,meta分析,评审

    doi:10.1177/0269216316663976

    authors: Chen CH,Kuo SC,Tang ST

    更新日期:2017-05-01 00:00:00

  • Inviting the absent members: examining how caregivers' participation affects hospice team communication.

    abstract::This paper is a secondary observation of a larger pilot study. The Assessing Caregivers for Team Intervention via Video Encounters intervention project enabled caregiver participation in hospice interdisciplinary team meetings. This paper used the team observation scale to assess the impact of caregiver involvement on...

    journal_title:Palliative medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1177/0269216309352066

    authors: Wittenberg-Lyles E,Oliver DP,Demiris G,Burt S,Regehr K

    更新日期:2010-03-01 00:00:00

  • Clinical research in palliative care: choice of trial design.

    abstract::Prospective controlled clinical trials provide the highest level of evidence in palliative care. Both parallel and crossover studies have unique advantages and disadvantages. Excellent knowledge of the patient population, interventions and endpoints are useful in choosing the most appropriate trial. Open pilot studies...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1191/026921601678576275

    authors: Mazzocato C,Sweeney C,Bruera E

    更新日期:2001-05-01 00:00:00

  • Attitudes toward euthanasia among Swedish medical students.

    abstract::Attitudes toward euthanasia differ between individuals and populations, and in many studies the medical profession is more reluctant than the general public. Our goal was to explore medical students' attitude toward euthanasia. A questionnaire containing open-ended questions was answered anonymously by 165 first- and ...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1177/0269216307081940

    authors: Karlsson M,Strang P,Milberg A

    更新日期:2007-10-01 00:00:00

  • Exploring factors and caregiver outcomes associated with feelings of preparedness for caregiving in family caregivers in palliative care: a correlational, cross-sectional study.

    abstract:BACKGROUND:Family caregivers in palliative care often report feeling insufficiently prepared to handle the caregiver role. Preparedness has been confirmed as a variable that may actually protect family caregiver well-being. Preparedness refers to how ready family caregivers perceive they are for the tasks and demands i...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1177/0269216313486954

    authors: Henriksson A,Årestedt K

    更新日期:2013-07-01 00:00:00

  • Living with severe chronic obstructive pulmonary disease (COPD): perceptions of patients and their carers. An interpretative phenomenological analysis.

    abstract:BACKGROUND:A study designed to explore the experiences of patients with severe chronic obstructive pulmonary disease (COPD) and their carers, particularly with regard to ongoing and palliative care needs. METHODS:The participants were nine men and one woman with severe COPD and the carers of eight of the men, in East ...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1191/0269216304pm928oa

    authors: Seamark DA,Blake SD,Seamark CJ,Halpin DM

    更新日期:2004-10-01 00:00:00

  • 'That's part of everybody's job': the perspectives of health care staff in England and New Zealand on the meaning and remit of palliative care.

    abstract:BACKGROUND:the right for patients of all diagnoses to be in receipt of palliative care from an early point in the diagnosis of a life-limiting condition is now enshrined in policy in a number of countries and increased emphasis is placed upon the role of generalist palliative care. However, little is known as to how th...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1177/0269216311408993

    authors: Gott M,Seymour J,Ingleton C,Gardiner C,Bellamy G

    更新日期:2012-04-01 00:00:00

  • Access and equity in HIV/AIDS palliative care: a review of the evidence and responses.

    abstract::The high prevalence of pain and other symptoms throughout the HIV disease trajectory, the need for management of side effects related to antiretroviral therapy, the continuing incidence of cancers and new emerging co-morbidities as a result of extended life expectancy under new therapeutic regimes, and the ongoing nee...

    journal_title:Palliative medicine

    pub_type: 杂志文章,评审

    doi:10.1191/0269216305pm1005oa

    authors: Harding R,Easterbrook P,Higginson IJ,Karus D,Raveis VH,Marconi K

    更新日期:2005-04-01 00:00:00

  • Illness awareness in terminal cancer patients: an Italian study.

    abstract::The amount and quality of information and awareness in cancer patients' is a topic frequently debated, but few studies have focussed on terminal patients. This is the objective of the present study that involved two different palliative home-care units in Italy, which recruited 550 terminal cancer patients. Data from ...

    journal_title:Palliative medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1177/0269216308100772

    authors: Corli O,Apolone G,Pizzuto M,Cesaris L,Cozzolino A,Orsi L,Enterri L

    更新日期:2009-06-01 00:00:00

  • Improving the delivery of palliative care in general practice: an evaluation of the first phase of the Gold Standards Framework.

    abstract:BACKGROUND:The Gold Standards Framework (GSF) was developed to improve the delivery of palliative care in general practice. AIM:The aim of the study was to evaluate the first phase of GSF in terms of its acceptability to primary care teams, effectiveness in changing practice and professionals' views on the consequence...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1177/0269216306072501

    authors: Thomas K,Noble B

    更新日期:2007-01-01 00:00:00

  • Methodological challenges in researching psychological distress and psychiatric morbidity among patients with advanced cancer: what does the literature (not) tell us?

    abstract::Patients with advanced cancer experience multiple demands and losses that place them at risk for experiencing psychological distress. Researchers can face challenges in conducting research among this population because of their poor levels of physical and cognitive functioning. This paper aims to develop our understan...

    journal_title:Palliative medicine

    pub_type: 杂志文章,评审

    doi:10.1177/0269216311399663

    authors: Ryan D,Gallagher P,Wright S,Cassidy E

    更新日期:2012-03-01 00:00:00

  • Opioid purchases and expenditure in nine western European countries: 'are we killing off morphine?'.

    abstract:BACKGROUND:In clinical practice the major role of opioid drugs is the management of malignant and nonmalignant pain. The primary aim of this study is to evaluate the trend in sales of four opioid analgesic drugs (codeine, tramadol, morphine, fentanyl), from wholesalers to community pharmacies, as an indicator of opioid...

    journal_title:Palliative medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1191/0269216305pm1002oa

    authors: De Conno F,Ripamonti C,Brunelli C

    更新日期:2005-04-01 00:00:00

  • Illicit drug use as a challenge to the delivery of end-of-life care services to homeless persons: perceptions of health and social services professionals.

    abstract::Homeless persons tend to die younger than the housed population and have complex, often unmet, end-of-life care needs. High levels of illicit drug use among this population are a particular challenge for health and social services professionals involved in end-of-life care services delivery. This article explores the ...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1177/0269216311402713

    authors: McNeil R,Guirguis-Younger M

    更新日期:2012-06-01 00:00:00

  • Educational opportunities in palliative care: what do general practitioners want?

    abstract::It is important to support general practitioners (GPs) in maintaining and developing their palliative care skills as most of the final year of a patient's life is spent at home under the care of the primary health care team. The training needs and uptake of GPs have been explored, but little is known about how GP educ...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1191/026921601678576176

    authors: Shipman C,Addington-Hall J,Barclay S,Briggs J,Cox I,Daniels L,Millar D

    更新日期:2001-05-01 00:00:00