Assessing the implementation and effectiveness of early integrated palliative care in long-term care facilities in France: an interventional mixed-methods study protocol
Abstract Background Majority of residents in long-term care facilities (LTCF) have limited and delayed access to palliative care even though many suffer from incurable chronic illnesses that will likely require the provision of palliative care. We present the study protocol of “PADI-Palli”, an inter...
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | BMC Palliative Care |
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| Online Access: | https://doi.org/10.1186/s12904-023-01157-w |
| _version_ | 1827970234721501184 |
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| author | Emmanuel Bagaragaza Isabelle Colombet Mireille Perineau Philippe Aegerter Frédéric Guirimand |
| author_facet | Emmanuel Bagaragaza Isabelle Colombet Mireille Perineau Philippe Aegerter Frédéric Guirimand |
| author_sort | Emmanuel Bagaragaza |
| collection | DOAJ |
| description | Abstract Background Majority of residents in long-term care facilities (LTCF) have limited and delayed access to palliative care even though many suffer from incurable chronic illnesses that will likely require the provision of palliative care. We present the study protocol of “PADI-Palli”, an intervention aims to advance early integrated palliative care into standard care delivered in LTCF. This study will assess the effectiveness of early integrated palliative care on palliative care accessibility for older persons in LTCF, and identify the key factors for the successful implementation of early integrated palliative care and its sustainability in the LTCF context. Methods This multicentre interventional study utilises a pragmatic research design with a convergent parallel mixed-methods approach. The qualitative study will use a case study design and the quantitative study will use a stepped wedge cluster randomised trial. In total, 21 participating LTCF from three French regions will be randomly allocated to one of seven clusters. The clusters will cross over from the usual care to the active intervention condition over the course of the study. The primary outcome relates to the accurate identification of palliative care needs and early access to palliative care for LTCF residents. Secondary outcomes are quality of care, quality of life for residents and their families, and quality of life at work for professionals. Measurements will be performed before and after the intervention. Implementation and evaluation of PADI-Palli intervention is grounded in the Consolidated Framework for Implementation Research. Discussion Existing evidence demonstrates that early integrated palliative care in cancer care leads to a significant improvement in patient outcomes and processes of care. Little is known, however, about early integrated palliative care in the context of LTCF for older persons. This study has the potential to fill this gap in the literature by providing evidence on the effectiveness of early integrated palliative care for older persons in LTCF. Moreover, this study will provide a better understanding of the relevant contextual elements that facilitate or hinder early integrated palliative care implementation and transferability. If proven effective, this intervention can be scaled to other care settings in which older persons require palliative care. Trial registration ClinicalTrials.gov ID: NCT04708002; National registration: ID-RCB number: 2020-A01832-37. |
| first_indexed | 2024-04-09T18:50:47Z |
| format | Article |
| id | doaj.art-8db03c5c4bfa484a8644574c88f2a7b1 |
| institution | Directory Open Access Journal |
| issn | 1472-684X |
| language | English |
| last_indexed | 2024-04-09T18:50:47Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Palliative Care |
| spelling | doaj.art-8db03c5c4bfa484a8644574c88f2a7b12023-04-09T11:29:45ZengBMCBMC Palliative Care1472-684X2023-04-0122111110.1186/s12904-023-01157-wAssessing the implementation and effectiveness of early integrated palliative care in long-term care facilities in France: an interventional mixed-methods study protocolEmmanuel Bagaragaza0Isabelle Colombet1Mireille Perineau2Philippe Aegerter3Frédéric Guirimand4Maison Médicale Jeanne Garnier, Département Recherche Enseignement Formation (DREF)Maison Médicale Jeanne Garnier, Département Recherche Enseignement Formation (DREF)Centre Hospitalier d’AvignonUniversité de Versailles Saint-Quentin-en-Yvelines Département Santé Publique - U1018 UVSQ INSERM, GIRCI IdFMaison Médicale Jeanne Garnier, Département Recherche Enseignement Formation (DREF)Abstract Background Majority of residents in long-term care facilities (LTCF) have limited and delayed access to palliative care even though many suffer from incurable chronic illnesses that will likely require the provision of palliative care. We present the study protocol of “PADI-Palli”, an intervention aims to advance early integrated palliative care into standard care delivered in LTCF. This study will assess the effectiveness of early integrated palliative care on palliative care accessibility for older persons in LTCF, and identify the key factors for the successful implementation of early integrated palliative care and its sustainability in the LTCF context. Methods This multicentre interventional study utilises a pragmatic research design with a convergent parallel mixed-methods approach. The qualitative study will use a case study design and the quantitative study will use a stepped wedge cluster randomised trial. In total, 21 participating LTCF from three French regions will be randomly allocated to one of seven clusters. The clusters will cross over from the usual care to the active intervention condition over the course of the study. The primary outcome relates to the accurate identification of palliative care needs and early access to palliative care for LTCF residents. Secondary outcomes are quality of care, quality of life for residents and their families, and quality of life at work for professionals. Measurements will be performed before and after the intervention. Implementation and evaluation of PADI-Palli intervention is grounded in the Consolidated Framework for Implementation Research. Discussion Existing evidence demonstrates that early integrated palliative care in cancer care leads to a significant improvement in patient outcomes and processes of care. Little is known, however, about early integrated palliative care in the context of LTCF for older persons. This study has the potential to fill this gap in the literature by providing evidence on the effectiveness of early integrated palliative care for older persons in LTCF. Moreover, this study will provide a better understanding of the relevant contextual elements that facilitate or hinder early integrated palliative care implementation and transferability. If proven effective, this intervention can be scaled to other care settings in which older persons require palliative care. Trial registration ClinicalTrials.gov ID: NCT04708002; National registration: ID-RCB number: 2020-A01832-37.https://doi.org/10.1186/s12904-023-01157-wOlder personsEarly palliative careInterventional researchLong-term careImplementationQuality improvement |
| spellingShingle | Emmanuel Bagaragaza Isabelle Colombet Mireille Perineau Philippe Aegerter Frédéric Guirimand Assessing the implementation and effectiveness of early integrated palliative care in long-term care facilities in France: an interventional mixed-methods study protocol BMC Palliative Care Older persons Early palliative care Interventional research Long-term care Implementation Quality improvement |
| title | Assessing the implementation and effectiveness of early integrated palliative care in long-term care facilities in France: an interventional mixed-methods study protocol |
| title_full | Assessing the implementation and effectiveness of early integrated palliative care in long-term care facilities in France: an interventional mixed-methods study protocol |
| title_fullStr | Assessing the implementation and effectiveness of early integrated palliative care in long-term care facilities in France: an interventional mixed-methods study protocol |
| title_full_unstemmed | Assessing the implementation and effectiveness of early integrated palliative care in long-term care facilities in France: an interventional mixed-methods study protocol |
| title_short | Assessing the implementation and effectiveness of early integrated palliative care in long-term care facilities in France: an interventional mixed-methods study protocol |
| title_sort | assessing the implementation and effectiveness of early integrated palliative care in long term care facilities in france an interventional mixed methods study protocol |
| topic | Older persons Early palliative care Interventional research Long-term care Implementation Quality improvement |
| url | https://doi.org/10.1186/s12904-023-01157-w |
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