Identification and characteristics of patients with palliative care needs in Brazilian primary care

Marcucci, Fernando C.I., Cabrera, Marcos A.S., Perilla, Anamaria Baquero, Brun, Marilia Maroneze, de Barros, Eder Marcos L., Martins, Vanessa M., Rosenberg, John P., & Yates, Patsy (2016) Identification and characteristics of patients with palliative care needs in Brazilian primary care. BMC Palliative Care, 15(51).

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Abstract

Background

  • The Brazilian healthcare system offers universal coverage but lacks information about how patients with PC needs are serviced by its primary care program, Estratégia Saúde da Família (ESF).

Methods

  • Cross-sectional study in community settings. Patients in ESF program were screened using a Palliative Care Screening Tool (PCST). Included patients were assessed with Karnofsky Performance Scale (KPS), Edmonton Symptom Assessment System (ESAS) and Palliative Care Outcome Scale (POS).

Results

  • Patients with PC needs are accessing the ESF program regardless of there being no specific PC support provided. From 238 patients identified, 73 (43 women, 30 men) were identified as having a need for PC, and the mean age was 77.18 (95 % Confidence Interval = ±2,78) years, with non-malignant neurologic conditions, such as dementia and cerebrovascular diseases, being the most common (53 % of all patients). Chronic conditions (2 or more years) were found in 70 % of these patients, with 71 % scoring 50 or less points in the KPS. Overall symptom intensity was low, with the exception of some cases with moderate and high score, and POS average score was 14.16 points (minimum = 4; maximum = 28). Most patients received medication and professional support through the primary care units, but limitations of services were identified, including lack of home visits and limited multi-professional approaches.

Conclusion

  • Patients with PC needs were identified in ESF program. Basic health care support is provided but there is a lack of attention to some specific needs. PC policies and professional training should be implemented to improve this area.

Impact and interest:

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ID Code: 96091
Item Type: Journal Article
Refereed: Yes
Keywords: Palliative care – Primary health care – Family health – Government Programs
DOI: 10.1186/s12904-016-0125-4
ISSN: 1472-684X
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Nursing
Copyright Owner: 2016 The Author(s)
Copyright Statement: Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Deposited On: 14 Jun 2016 21:55
Last Modified: 17 Jun 2016 00:04

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