Development of a complex intervention for early integration of palliative home care into standard care for end-stage COPD patients: A Phase 0-I study.

BACKGROUND:Research suggests that palliative home care should be integrated early into standard care for end-stage COPD patients. Patients also express the wish to be cared for and to die at home. However, a practice model for early integration of palliative home care (PHC) into standard care for en...

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Main Authors: Charlotte Scheerens, Kenneth Chambaere, Koen Pardon, Eric Derom, Simon Van Belle, Guy Joos, Peter Pype, Luc Deliens
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2018-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC6145576?pdf=render
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spelling doaj-7c992c6234d744b18a502a886a7a28c22020-11-25T00:02:21ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01139e020332610.1371/journal.pone.0203326Development of a complex intervention for early integration of palliative home care into standard care for end-stage COPD patients: A Phase 0-I study.Charlotte ScheerensKenneth ChambaereKoen PardonEric DeromSimon Van BelleGuy JoosPeter PypeLuc DeliensBACKGROUND:Research suggests that palliative home care should be integrated early into standard care for end-stage COPD patients. Patients also express the wish to be cared for and to die at home. However, a practice model for early integration of palliative home care (PHC) into standard care for end-stage COPD has not been fully developed. AIM:To develop an intervention for early integration of PHC into standard care for end-stage COPD patients. METHODS:We conducted a Phase 0-I study according to the Medical Research Council Framework for the development of complex interventions. Phase 0 aimed to identify the inclusion criteria and key components of the intervention by way of an explorative literature search of interventions, expert consultations, and seven focus groups with general practitioners and community nurses on perceived barriers to and facilitators of early integrated PHC for COPD. In Phase 1, the intervention, its inclusion criteria and its components were developed and further refined by an expert panel and two expert opinions. RESULTS:Phase 0 resulted in identification of inclusion criteria and components from existing interventions, and barriers to and facilitators of early integration of PHC for end-stage COPD. Based on these findings, a nurse-led intervention was developed in Phase I consisting of training for PHC nurses in symptom recognition and physical therapy exercises for end-stage COPD, regular visits by PHC nurses at the patients' homes, two information leaflets on self-management, a semi-structured protocol and follow-up plan to record the outcomes of the home visits, and integration of care by enabling collaboration and communication between home and hospital-based professional caregivers. CONCLUSION:This Phase 0-I trial succeeded in developing a complex intervention for early integration of PHC for end-stage COPD. The use of three methods in Phase 0 gave reliable data on which to base inclusion criteria and components of the intervention. The preliminary effectiveness, feasibility and acceptability of the intervention will be subsequently tested in a Phase II study.http://europepmc.org/articles/PMC6145576?pdf=render
collection DOAJ
language English
format Article
sources DOAJ
author Charlotte Scheerens
Kenneth Chambaere
Koen Pardon
Eric Derom
Simon Van Belle
Guy Joos
Peter Pype
Luc Deliens
spellingShingle Charlotte Scheerens
Kenneth Chambaere
Koen Pardon
Eric Derom
Simon Van Belle
Guy Joos
Peter Pype
Luc Deliens
Development of a complex intervention for early integration of palliative home care into standard care for end-stage COPD patients: A Phase 0-I study.
PLoS ONE
author_facet Charlotte Scheerens
Kenneth Chambaere
Koen Pardon
Eric Derom
Simon Van Belle
Guy Joos
Peter Pype
Luc Deliens
author_sort Charlotte Scheerens
title Development of a complex intervention for early integration of palliative home care into standard care for end-stage COPD patients: A Phase 0-I study.
title_short Development of a complex intervention for early integration of palliative home care into standard care for end-stage COPD patients: A Phase 0-I study.
title_full Development of a complex intervention for early integration of palliative home care into standard care for end-stage COPD patients: A Phase 0-I study.
title_fullStr Development of a complex intervention for early integration of palliative home care into standard care for end-stage COPD patients: A Phase 0-I study.
title_full_unstemmed Development of a complex intervention for early integration of palliative home care into standard care for end-stage COPD patients: A Phase 0-I study.
title_sort development of a complex intervention for early integration of palliative home care into standard care for end-stage copd patients: a phase 0-i study.
publisher Public Library of Science (PLoS)
series PLoS ONE
issn 1932-6203
publishDate 2018-01-01
description BACKGROUND:Research suggests that palliative home care should be integrated early into standard care for end-stage COPD patients. Patients also express the wish to be cared for and to die at home. However, a practice model for early integration of palliative home care (PHC) into standard care for end-stage COPD has not been fully developed. AIM:To develop an intervention for early integration of PHC into standard care for end-stage COPD patients. METHODS:We conducted a Phase 0-I study according to the Medical Research Council Framework for the development of complex interventions. Phase 0 aimed to identify the inclusion criteria and key components of the intervention by way of an explorative literature search of interventions, expert consultations, and seven focus groups with general practitioners and community nurses on perceived barriers to and facilitators of early integrated PHC for COPD. In Phase 1, the intervention, its inclusion criteria and its components were developed and further refined by an expert panel and two expert opinions. RESULTS:Phase 0 resulted in identification of inclusion criteria and components from existing interventions, and barriers to and facilitators of early integration of PHC for end-stage COPD. Based on these findings, a nurse-led intervention was developed in Phase I consisting of training for PHC nurses in symptom recognition and physical therapy exercises for end-stage COPD, regular visits by PHC nurses at the patients' homes, two information leaflets on self-management, a semi-structured protocol and follow-up plan to record the outcomes of the home visits, and integration of care by enabling collaboration and communication between home and hospital-based professional caregivers. CONCLUSION:This Phase 0-I trial succeeded in developing a complex intervention for early integration of PHC for end-stage COPD. The use of three methods in Phase 0 gave reliable data on which to base inclusion criteria and components of the intervention. The preliminary effectiveness, feasibility and acceptability of the intervention will be subsequently tested in a Phase II study.
url http://europepmc.org/articles/PMC6145576?pdf=render
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