Contact information
Type
Scientific
Primary contact
Dr A.H. Blankenstein
ORCID ID
Contact details
Vrije University Medical Centre
EMGO-Institute
Van der Boechorststraat 7
Amsterdam
1081 BT
Netherlands
+31 (0)20 4448198
ah.blankenstein@vumc.nl
Additional identifiers
EudraCT number
ClinicalTrials.gov number
Protocol/serial number
NTR565
Study information
Scientific title
Acronym
COMPACT
Study hypothesis
GPs play a central role in providing palliative care (PC) in the Netherlands. Good GP-patient communication is essential for the delivery of high quality care. Communication in PC is difficult, involving a mix of physical, psychosocial, and spiritual issues. Because of barriers in communication, not all of the patients problems are clarified. Consequently, GPs will not take subsequent actions, and the quality of life of the patient may be unnecessarily impaired.
We developed the AAA assessment tool that enables GPs to identify the gaps in their PC communication skills and to formulate learning goals. Tailored communication exercises are offered, and finally the tool is used for self-evaluation of learned AAA skills. The effectiveness of this tool will be evaluated in a controlled clinical trial with outcome measures on GP and patient level.
It is hypothesised that, compared to existing PC courses, a training course on communication in PC guided by the AAA assessment tool will increase GPs competence in identifying and meeting the needs of PC patients more. As a result, patients will suffer less and be more satisfied with the PC they receive from their GPs.
Ethics approval
Received from the local medical ethics committee
Study design
Parallel group controlled trial
Primary study design
Interventional
Secondary study design
Non randomised controlled trial
Trial setting
GP practices
Trial type
Quality of life
Patient information sheet
Condition
Palliative care
Intervention
Based on the literature and preliminary studies, three key elements for GP-patient communication in PC were identified: Availability, Active listening, and Anticipating (AAA). Existing GP training programmes on communication in PC are in need of a tool for identifying GPs individual learning goals. The AAA assessment tool will enable GPs to gain insight in the quality of their communication skills in PC; this will increase the effectiveness of the learning process by helping to focus on the aspects GPs want to improve.
All participating GPs will attend a PC Peer Group Training Course, only the intervention group will attend the course with the AAA assessment tool integrated in the course. In the intervention group the AAA assessment tool will be implemented in the existing Peer Group Course as follows:
1. At the start, a consultation with a simulated PC patient is video-recorded and (a few weeks later) the GP receives feedback according to the AAA assessment tool. GPs will be invited to identify their gaps and to formulate personal learning goals, based on the received feedback.
2. During the residential course education modules on the AAA items will be offered: individual GPs participate in the module(s) that focus on their gaps.
3. During the peer group sessions GPs will apply the AAA assessment tool to give feedback on cases presented (orally, transcribed, or audio/video-taped) by their peers. This tailor-made intervention will focus on the aspects each individual GP wants to improve.
Intervention type
Other
Phase
Not Specified
Drug names
Primary outcome measures
The first research question, on effectiveness of the AAA assessment tool, will be measured by analysis of video-recorded consultations with simulated patients: the GP-patient communication in PC will be determined by the Roter Interaction Analysis System (RIAS).
This primary outcome will also be measured according to a study-specific AAA rating scale.
Twice during the project GPs will be video-taped (consultation with a simulated patient); the first time will be during the first 2-day course (before the start of the intervention); the second time will be during the third 2-day course (one year later).
Secondary outcome measures
Effects at patient level will be measured by questionnaires to real PC patients:
1. Satisfaction about the communication with their GP will be measured with the Dutch version of the Patient Satisfaction Questionnaire III
2. Disease-related quality of life will be measured with the Palliative Care Outcome Scale and the EORTC QLQ-C15-PAL
3. Feelings of being at peace and comfortable will be measured according to a study-specific rest & peace rating scale
4. Implementation of AAA items by GPs will be measured by a study-specific 'AAA Patient Questionnaire'
Twice during the project GPs will be asked to recruit the first two consecutive patients for whom they currently provide PC, and who are eligible for participation. The first time will be during the three months before the start of the course; the second time will be between the second and third 2-day course.
Overall trial start date
01/03/2006
Overall trial end date
31/12/2009
Reason abandoned
Eligibility
Participant inclusion criteria
1. Incurable cancer with a life-expectancy of less than six months
2. Over 18 years of age
3. Ability to speak, read and write Dutch
4. Absence of overt psychopathology or serious cognitive dysfunction that would impede their ability to take part in the study
5. Written informed consent
Participant type
Patient
Age group
Adult
Gender
Both
Target number of participants
640
Participant exclusion criteria
Does not comply with the above inclusion criteria
Recruitment start date
01/03/2006
Recruitment end date
31/12/2009
Locations
Countries of recruitment
Netherlands
Trial participating centre
Vrije University Medical Centre
Amsterdam
1081 BT
Netherlands
Sponsor information
Organisation
Vrije University Medical Centre (VUMC) (The Netherlands)
Sponsor details
EMGO Institute
Van der Boechorststraat 7
Amsterdam
1081 BT
Netherlands
+31 (0)20 4448180
emgo@vumc.nl
Sponsor type
Hospital/treatment centre
Website
Funders
Funder type
Industry
Funder name
OZ Health Insurance NV (OZ Zorgverzekeringen NV) (The Netherlands)
Alternative name(s)
Funding Body Type
Funding Body Subtype
Location
Funder name
Comprehensive Cancer Centre South (IKZ Eindhoven) (The Netherlands)
Alternative name(s)
Funding Body Type
Funding Body Subtype
Location
Funder name
Pfizer (The Netherlands)
Alternative name(s)
Pfizer Inc.
Funding Body Type
private sector organisation
Funding Body Subtype
corporate
Location
United States of America
Funder name
Janivo Foundation (The Netherlands)
Alternative name(s)
Funding Body Type
Funding Body Subtype
Location
Results and Publications
Publication and dissemination plan
Not provided at time of registration
Intention to publish date
Participant level data
Not provided at time of registration
Results - basic reporting
Publication summary
2013 results in: http://www.ncbi.nlm.nih.gov/pubmed/23819723
2014 results in: http://www.ncbi.nlm.nih.gov/pubmed/24951633
Publication citations
-
Results
Slort W, Blankenstein AH, Schweitzer BP, Knol DL, Deliens L, Aaronson NK, van der Horst HE, Effectiveness of the ACA (Availability, Current issues and Anticipation) training programme on GP-patient communication in palliative care; a controlled trial., BMC Fam Pract, 2013, 14, 93, doi: 10.1186/1471-2296-14-93.
-
Results
Slort W, Blankenstein AH, Schweitzer BP, Knol DL, van der Horst HE, Aaronson NK, Deliens L, Effectiveness of the palliative care 'Availability, Current issues and Anticipation' (ACA) communication training programme for general practitioners on patient outcomes: A controlled trial., Palliat Med, 2014, 28, 8, 1036-1045, doi: 10.1177/0269216314538302.