palliAGEDgp: equipping GPs in rural and remote areas to deliver quality palliative care
A blog post written by Professor Jennifer Tieman, CareSearch Director, Matthew Flinders Fellow, College of Nursing and Health Sciences, Flinders University
The need to provide quality palliative care for older Australians, particularly those who are residing in aged care facilities has become increasingly pressing. With our increasing ageing population, and the challenge of more elderly Australians living longer with dementia and multi-morbidities, it is indeed important to ensure quality, person-centred care.
GPs have a key role in providing care for older people and for people who have life limiting illnesses living at home, with family members or in aged care facilities. Indeed, with our increasing life expectancy and ageing population, GPs are now more and more taking care of people with chronic conditions that are likely to progress to life-limiting illness and death. Recognising palliative care needs and supporting care delivery over time requires skills and knowledge at the right time. However, many GPs, face barriers in delivering palliative care and support. In rural and remote areas, the lack of services and facilities, as well as the higher levels of disease and death rates means more workload for GPs. Also adding to the challenge is their lack of access to tools and resources to guide clinical decisions for complex cases.
In 2015, we released the palliAGEDgp smartphone app to provide all GPs with a free accessible, and evidence-based resource to help in their clinical decision-making. We built palliAGEDgp around a framework for palliative care and based on three prognostic trajectories: advance care planning (All Your Older Patients section), case conferencing (As Things Change section), and terminal care management (When Your Patient is Dying section). Prescribing guidance forms a core component of the palliAGEDgp content, and is included under the When Your Patient is Dying section.
The app has a web version so it can also be viewed in through a desktop computer. Further, it also has an offline capacity so that once downloaded, it can be used without a web connection. This feature is particularly helpful in rural and remote areas where digital connectivity can be intermittent.
The palliAGEDgp app has been downloaded 5,895 times since it was launched. At least eight of the 31 Primary Health care Networks have embedded palliAGEDgp into software for clinical GPs. In addition to this, according to the organisation that supports the online Health Pathways software for GPs, palliAGEDgp has been referenced in 16 different instances on live pathways.
However, the real value of such resources is in the stories of people who use them. Dr Holly Deer is a GP who works in a regional area in SA. She reminds us that GPs play a critical role in meeting the needs of people living in country areas in a video about how she uses the palliAGEDapp when providing care.
Professor Jennifer Tieman, CareSearch Director, Matthew Flinders Fellow, College of Nursing and Health Sciences, Flinders University