Palliative Care Needs in Primary Health Care: Characteristics of Patients with Advanced Cancer and Dementia
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/20049 |
Resumo: | Introduction: The increase in life expectancy brought a higher prevalence of chronic diseases, with an emphasis on those who reached advanced stages and required palliative care. We aimed to characterize patients diagnosed with advanced neoplasms and/or dementia accompanied in primary health care and to test the sensitivity of two tools for identifying patients with palliative needs.Methods: We recruited three voluntary family physicians who provided data relative to 623 patients with active codification for neoplasm and/or dementia on the MIM@UF platform. We defined ‘patient with palliative needs’ as any patient with this codification in advanced stadium and made their clinical and sociodemographic characterization. Assuming the existence of advanced-stage disease as the gold standard, we calculated and compared the sensitivities of each of the tools under study: the surprise question, the question ‘do you think this patient has palliative needs?’ and an instrument that corresponded to identification by at least one of the questions.Results: Among the analyzed data, there were 559 (89.7%) active codifications of neoplasm and 64 (10.3%) of dementia; the prevalence of advanced neoplasm and dementia was 1.0% in the studied sample. The subgroup of patients with advanced dementia showed female sex predominance, an older age, and less access to health care. In both subgroups there was a scarcity of data related to education and income, and we observed polypharmacotherapy and multimorbidity. The sensitivity of the surprise question was 33.3% for neoplasia and 69.3% for dementia; of the new tool 50.0% for neoplasia and 92.3% for dementia; and, when used together, 55.6% for neoplasia and 92.3% for dementia.Conclusion: Our results help characterize two subpopulations of patients in need of palliative care and advance with a possible tool for their identification, to be confirmed in a representative sample. |
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Palliative Care Needs in Primary Health Care: Characteristics of Patients with Advanced Cancer and DementiaNecessidades Paliativas em Cuidados de Saúde Primários: Características dos Doentes com Neoplasia e Demência AvançadasDementiaNeoplasmsPalliative CarePrimary Health CareCuidados de Saúde PrimáriosCuidados PaliativosDemênciaNeoplasiaIntroduction: The increase in life expectancy brought a higher prevalence of chronic diseases, with an emphasis on those who reached advanced stages and required palliative care. We aimed to characterize patients diagnosed with advanced neoplasms and/or dementia accompanied in primary health care and to test the sensitivity of two tools for identifying patients with palliative needs.Methods: We recruited three voluntary family physicians who provided data relative to 623 patients with active codification for neoplasm and/or dementia on the MIM@UF platform. We defined ‘patient with palliative needs’ as any patient with this codification in advanced stadium and made their clinical and sociodemographic characterization. Assuming the existence of advanced-stage disease as the gold standard, we calculated and compared the sensitivities of each of the tools under study: the surprise question, the question ‘do you think this patient has palliative needs?’ and an instrument that corresponded to identification by at least one of the questions.Results: Among the analyzed data, there were 559 (89.7%) active codifications of neoplasm and 64 (10.3%) of dementia; the prevalence of advanced neoplasm and dementia was 1.0% in the studied sample. The subgroup of patients with advanced dementia showed female sex predominance, an older age, and less access to health care. In both subgroups there was a scarcity of data related to education and income, and we observed polypharmacotherapy and multimorbidity. The sensitivity of the surprise question was 33.3% for neoplasia and 69.3% for dementia; of the new tool 50.0% for neoplasia and 92.3% for dementia; and, when used together, 55.6% for neoplasia and 92.3% for dementia.Conclusion: Our results help characterize two subpopulations of patients in need of palliative care and advance with a possible tool for their identification, to be confirmed in a representative sample.Introdução: O aumento da esperança de vida trouxe maior prevalência de doenças crónicas, merecendo destaque as que atingem estádios avançados e que requerem cuidados paliativos. Pretendeu-se caracterizar os doentes com diagnóstico de neoplasia e/ou demência em estádio avançado, acompanhados em cuidados de saúde primários, e testar a sensibilidade de duas ferramentas para identificação de doentes com necessidades paliativas.Métodos: Recrutámos três médicos de família voluntários que forneceram dados relativos a 623 doentes com codificação ativa de neoplasia e/ou demência na plataforma MIM@UF. Definimos como ‘doente com necessidades paliativas’ todo o doente com doença em estádio avançado, e fizemos a sua caracterização clínica e sociodemográfica. Assumindo como gold standard a existência de doença em estádio avançado, calculámos e comparámos as sensibilidades de cada uma das ferramentas em estudo: a questão surpresa, a questão ‘acha que este doente tem necessidades paliativas?’ e um instrumento que correspondesse a identificação por pelo menos uma das questões.Resultados: De entre os dados analisados, existiram 559 (89,7%) codificações ativas de neoplasia e 64 (10,3%) de demência; a prevalência de neoplasia e demência avançadas foi de 1,0% na amostra estudada. O subgrupo de doentes com demência avançada mostrou predomínio do sexo feminino, idade superior e menor acesso a cuidados de saúde. Em ambos os subgrupos houve escassez de dados relativos à escolaridade e rendimento e observámos polifarmacoterapia e multimorbilidade. A sensibilidade da questão surpresa foi de 33,3% para neoplasia e 69,3% para demência; da nova ferramenta de 50,0% para neoplasia e 92,3% para demência; e, quando usadas em conjunto, de 55,6% para neoplasia e 92,3% para demência.Conclusão: Estes resultados ajudam a caracterizar duas subpopulações de doentes com necessidade de cuidados paliativos e avançam com uma possível ferramenta para sua identificação, a confirmar a sua utilidade numa amostra representativa.Ordem dos Médicos2023-08-10info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/20049Acta Médica Portuguesa; Vol. 37 No. 2 (2024): February; 90-99Acta Médica Portuguesa; Vol. 37 N.º 2 (2024): Fevereiro; 90-991646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/20049https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/20049/15197https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/20049/15195https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/20049/15196Direitos de Autor (c) 2023 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessPires, LuísRosendo, InêsSeiça Cardoso, Carlos2024-02-04T03:00:39Zoai:ojs.www.actamedicaportuguesa.com:article/20049Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T20:26:56.201401Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Palliative Care Needs in Primary Health Care: Characteristics of Patients with Advanced Cancer and Dementia Necessidades Paliativas em Cuidados de Saúde Primários: Características dos Doentes com Neoplasia e Demência Avançadas |
title |
Palliative Care Needs in Primary Health Care: Characteristics of Patients with Advanced Cancer and Dementia |
spellingShingle |
Palliative Care Needs in Primary Health Care: Characteristics of Patients with Advanced Cancer and Dementia Pires, Luís Dementia Neoplasms Palliative Care Primary Health Care Cuidados de Saúde Primários Cuidados Paliativos Demência Neoplasia |
title_short |
Palliative Care Needs in Primary Health Care: Characteristics of Patients with Advanced Cancer and Dementia |
title_full |
Palliative Care Needs in Primary Health Care: Characteristics of Patients with Advanced Cancer and Dementia |
title_fullStr |
Palliative Care Needs in Primary Health Care: Characteristics of Patients with Advanced Cancer and Dementia |
title_full_unstemmed |
Palliative Care Needs in Primary Health Care: Characteristics of Patients with Advanced Cancer and Dementia |
title_sort |
Palliative Care Needs in Primary Health Care: Characteristics of Patients with Advanced Cancer and Dementia |
author |
Pires, Luís |
author_facet |
Pires, Luís Rosendo, Inês Seiça Cardoso, Carlos |
author_role |
author |
author2 |
Rosendo, Inês Seiça Cardoso, Carlos |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Pires, Luís Rosendo, Inês Seiça Cardoso, Carlos |
dc.subject.por.fl_str_mv |
Dementia Neoplasms Palliative Care Primary Health Care Cuidados de Saúde Primários Cuidados Paliativos Demência Neoplasia |
topic |
Dementia Neoplasms Palliative Care Primary Health Care Cuidados de Saúde Primários Cuidados Paliativos Demência Neoplasia |
description |
Introduction: The increase in life expectancy brought a higher prevalence of chronic diseases, with an emphasis on those who reached advanced stages and required palliative care. We aimed to characterize patients diagnosed with advanced neoplasms and/or dementia accompanied in primary health care and to test the sensitivity of two tools for identifying patients with palliative needs.Methods: We recruited three voluntary family physicians who provided data relative to 623 patients with active codification for neoplasm and/or dementia on the MIM@UF platform. We defined ‘patient with palliative needs’ as any patient with this codification in advanced stadium and made their clinical and sociodemographic characterization. Assuming the existence of advanced-stage disease as the gold standard, we calculated and compared the sensitivities of each of the tools under study: the surprise question, the question ‘do you think this patient has palliative needs?’ and an instrument that corresponded to identification by at least one of the questions.Results: Among the analyzed data, there were 559 (89.7%) active codifications of neoplasm and 64 (10.3%) of dementia; the prevalence of advanced neoplasm and dementia was 1.0% in the studied sample. The subgroup of patients with advanced dementia showed female sex predominance, an older age, and less access to health care. In both subgroups there was a scarcity of data related to education and income, and we observed polypharmacotherapy and multimorbidity. The sensitivity of the surprise question was 33.3% for neoplasia and 69.3% for dementia; of the new tool 50.0% for neoplasia and 92.3% for dementia; and, when used together, 55.6% for neoplasia and 92.3% for dementia.Conclusion: Our results help characterize two subpopulations of patients in need of palliative care and advance with a possible tool for their identification, to be confirmed in a representative sample. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-08-10 |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/20049 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/20049 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/20049 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/20049/15197 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/20049/15195 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/20049/15196 |
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Direitos de Autor (c) 2023 Acta Médica Portuguesa info:eu-repo/semantics/openAccess |
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Direitos de Autor (c) 2023 Acta Médica Portuguesa |
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Ordem dos Médicos |
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Ordem dos Médicos |
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Acta Médica Portuguesa; Vol. 37 No. 2 (2024): February; 90-99 Acta Médica Portuguesa; Vol. 37 N.º 2 (2024): Fevereiro; 90-99 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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