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Table 2 Objectives, outcome parameters, data collection/sources, work packages and timeline

From: Optimal care at the end of life (OPAL): study protocol of a prospective interventional mixed-methods study with pretest-posttest-design in a primary health care setting considering the view of general practitioners, relatives of deceased patients and health care stakeholders

Objective Outcome parameter Data collection/source Work package
Optimised care at the end of life Primary outcome: General Practice End of Life Care Index (GP-EoLC-I): clinical practice and organization of palliative care Standardized written surveys with GPs WP2a t0
WP2b t1
Secondary outcome: Situation of care, shared decision-making, advance care planning, consideration of therapeutic preferences, preferred place to live and to die. Guided interviews with relatives of deceased patients (after-death interviews) WP3a t0WP3b t1
Secondary outcome: Indicators for (palliative) care at the end of life based on the Bertelsmann foundation’s fact check 2015:
▪ Chemotherapy for cancer patients in the last month of life,
▪ Insertion of percutaneous endoscopic gastrostomy tube in the last three months of life,
▪ Number of hospitalisation and treatment days in the last six months of life,
▪ Number of patients with general outpatient PC treatments according to the Uniform Value Scale,
▪ Number of prescriptions for specialized outpatient PC and number of first prescriptions within the last three days of life,
▪ Average duration of general and specialized outpatient PC treatments,
▪ Number of patients who died in the hospital.
Clinical data of deceased patients of general practices WP4a t0WP4b t1
Comparative analysis of AOK datasets: Lower Saxony in total vs. Hameln-Pyrmont WP5a t0
WP5b t1
Application of the SPICT-DE Number of patients in whom the SPICT-DE was applied to identify a PC situation Patient records WP9
GPs’ awareness and sensibility for PC situations Number of patients considered eligible for PC; number of patients with general outpatient PC treatments; number of prescriptions for specialized outpatient PC Patient records
AOK datasets
WP8
WP5a t0
WP5b t1
Effectiveness and practical consequences for GPs Number of PC actions and interventions for identified patients (e.g. review of current treatment and medication, considering referral for specialist PC, advance care planning.) Patient records WP8
WP9
  1. t0: pre intervention (baseline), t1: post intervention
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