{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T04:27:23Z","timestamp":1769833643912,"version":"3.49.0"},"reference-count":29,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T00:00:00Z","timestamp":1705363200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Palliat Med"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec><jats:title>Background:<\/jats:title><jats:p> Evidence suggests that involving General Practitioners in the care of patients with palliative care needs may improve patient outcomes. <\/jats:p><\/jats:sec><jats:sec><jats:title>Aim:<\/jats:title><jats:p> To evaluate whether a two-tiered intervention involving training in palliative care and a new consultation model in primary care for patients with palliative care needs is feasible and could reduce patients\u2019 symptom burden. <\/jats:p><\/jats:sec><jats:sec><jats:title>Design:<\/jats:title><jats:p> Before-after study including an internal pilot. <\/jats:p><\/jats:sec><jats:sec><jats:title>Setting\/participants:<\/jats:title><jats:p> Nine general practitioners working in a health region in Portugal and 53 patients with palliative care needs from their patient lists were recruited. General Practitioners received training in palliative care and used a new primary palliative care consultation model, with medical consultations every 3\u2009weeks for 12\u2009weeks. The primary outcome was physical symptom burden, self-reported using the Integrated Palliative care Outcome Scale (IPOS) patient version (min.0\u2013max.1000). Secondary outcomes included emotional symptoms (min.0\u2013max.400) and communication\/practical issues (min.0\u2013max.300). <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> Of the 35\/53 patients completed the 12-week intervention (mean age 72.53\u2009years, SD\u2009=\u200913.45; 54.7% female). All had advanced disease: one third had cancer ( n\u2009=\u200913), one third had congestive heart failure ( n\u2009=\u200912); others had chronic kidney disease and chronic obstructive pulmonary disease. After the 12\u2009weeks of intervention, there was a reduction in physical symptom burden [mean difference from baseline of 71.42 (95%CI 37.01\u2013105.85) with a medium-large effect size (0.71], and in emotional symptom burden [mean difference 42.86 (95%CI 16.14\u201369.58), with a medium effect size (0.55)]. No difference was found for communication\/practical issues. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p> Our intervention can be effective in reducing patients\u2019 physical and emotional symptoms. <\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration:<\/jats:title><jats:p> ClinicalTrials.gov ID \u2013 NCT05244590. Registration: 14th February 2022. <\/jats:p><\/jats:sec>","DOI":"10.1177\/02692163231219682","type":"journal-article","created":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T09:58:38Z","timestamp":1705399118000},"page":"842-852","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Feasibility and effectiveness of a two-tiered intervention involving training and a new consultation model for patients with palliative care needs in primary care: A before-after study"],"prefix":"10.1177","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9214-6995","authenticated-orcid":false,"given":"Carlos","family":"Sei\u00e7a Cardoso","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Coimbra, Coimbra, Portugal"},{"name":"CINTESIS@RISE, MEDCIDS, Faculty of Medicine of the University of Porto, Porto, Portugal"}]},{"given":"Filipe","family":"Prazeres","sequence":"additional","affiliation":[{"name":"CINTESIS@RISE, MEDCIDS, Faculty of Medicine of the University of Porto, Porto, Portugal"},{"name":"Faculdade de Ci\u00eancias da Sa\u00fade, Universidade da Beira Interior, Covilh\u00e3, Portugal"},{"name":"USF Beira Ria, Gafanha da Nazar\u00e9, Portugal"}]},{"given":"B\u00e1rbara","family":"Oliveiros","sequence":"additional","affiliation":[{"name":"Laboratory of Biostatistics and Medical Informatics (LBIM), Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal"},{"name":"Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal"}]},{"given":"C\u00e1tia","family":"Nunes","sequence":"additional","affiliation":[{"name":"Family Health Unit Penacova, Coimbra, Portugal"}]},{"given":"Pedro","family":"Sim\u00f5es","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, University of Beira Interior, Covilh\u00e3, Portugal"},{"name":"Personalized Health Care Unit Fund\u00e3o, Fund\u00e3o, Portugal"}]},{"given":"Carolina","family":"Aires","sequence":"additional","affiliation":[{"name":"Family Health Unit S\u00e3o Martinho de Pombal, Pombal, Portugal"}]},{"given":"Patr\u00edcia","family":"Rita","sequence":"additional","affiliation":[{"name":"Personalized Health Care Unit Castanheira de Pera, Coimbra, Portugal"}]},{"given":"Joana","family":"Penetra","sequence":"additional","affiliation":[{"name":"Family Health Unit Top\u00e1zio, Coimbra, Portugal"}]},{"given":"Paulo","family":"Lopes","sequence":"additional","affiliation":[{"name":"Family Health Unit Rainha Santa Isabel, Torres Novas, Santar\u00e9m, Portugal"}]},{"given":"Sara","family":"Alcobia","sequence":"additional","affiliation":[{"name":"Family Health Unit As Gandras, Cantanhede, Coimbra, Portugal"}]},{"given":"Sara","family":"Baptista","sequence":"additional","affiliation":[{"name":"Personalized Health Care Unit Figueira-da-Foz Norte, Coimbra, Portugal"}]},{"given":"Carla","family":"Ven\u00e2ncio","sequence":"additional","affiliation":[{"name":"Family Health Unit Condeixa, Coimbra, Portugal"}]},{"given":"Barbara","family":"Gomes","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Coimbra, Coimbra, Portugal"},{"name":"Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King\u2019s College London, London, UK"}]}],"member":"179","published-online":{"date-parts":[[2024,1,16]]},"reference":[{"key":"bibr1-02692163231219682","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(19)30172-X"},{"key":"bibr2-02692163231219682","volume-title":"Integrating palliative care and symptom relief into primary health care: a WHO guide for planners, implementers and managers","author":"World Health Organization","year":"2018"},{"key":"bibr3-02692163231219682","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-060517"},{"key":"bibr4-02692163231219682","doi-asserted-by":"publisher","DOI":"10.5888\/pcd15.170475"},{"key":"bibr5-02692163231219682","volume":"374","author":"Skivington K","year":"2021","journal-title":"BMJ"},{"key":"bibr6-02692163231219682","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-022-03528-y"},{"key":"bibr7-02692163231219682","unstructured":"PORDATA. \u00cdndice de envelhecimento e outros indicadores de envelhecimento segundo os Censos. 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