Department of Geriatrics
Ghent University Hospital
Patient tailored treatment is one of the major objectives of geriatric medicine. The Department of Geriatrics of the Ghent University Hospital has developed a research unit concerned with tailored care in frail older persons.
Our research unit studies assessment and management of pain and other discomfort and spiritual concerns of frail older persons. Other topics of interest are patient-centered ACP conversations; inter-professional collaboration and ethical climate as means to improve end of life decision-making in frail persons.
Decisions to limit therapies or TLDs (treatment limitation decisions) in older persons are taken too little and too late, leading to too aggressive care at the end-of-life. Focusing on life-prolongation and aggressive treatments may be not beneficial and even harmful for patients and their families who wish to prepare for death and dying. SPICT may help clinicians to overcome prognostic paralysis.
By means of a multicenter prospective observational study (2017-2020) in older persons hospitalized in 4 hospitals we will address following research questions:
1. ‘Is SPICT an accurate tool to identify the older person with poor prospects (aiming at a very high sensitivity and a moderate to high specificity to predict 12 months mortality)?
2. ’Is SPICT needed in order to improve TLD decision-making? Is the association between TLD and SPICT score different in geriatric wards compared to older persons in non-geriatric wards?’ .
This project is supported by Fund Marie-Thérèse De Lava, King Baudouin Foundation, Belgium.
University of Antwerp
Pro-Spinoza is a Belgian research project supporting the implementation of the Care Pathway for Primary Palliative Care (CPPPC).
The project is performed by the Research Group Palliative Care of the University of Antwerp. Along this project, it is investigated how the Care Pathway is implemented in 5 Belgian regions, which starts by identification of palliative care patients with the surprise question and/or the SPICT. Furthermore, it will be investigated whether this Care Pathway can help to improve the quality of delivered palliative care.
On the English part of this website you will only find a summary of our work, but in the Dutch and the French parts of the website, you can find information about the “pro-Spinoza” project, both the clinically related information, like the handbook of palliative care, the care pathway algorithm and the care file, and the information related to the scientific evaluation of the project.
Université catholique de Louvain (UCLouvain), Institute of Health and Society (IRSS)
Clos Chapelle-aux-Champs, 30 bte 1.30.15 B-1200- Woluwe-Saint-Lambert, Belgium
The UCLouvain Institute of Health and Society (IRSS) provides high-quality, multidisciplinary research and scientific capacity building aimed at improving both the quality of life of individuals and also population health through innovation in public health and healthcare that is both socially responsible and evidence-based. Created in 2010, the general purpose of the Institute is to develop research activities that attempt to better understand physical, mental, social dimensions as well as the complex interactions that link them to individuals and the population on the subject of their health and well-being.
The Institute relies on the collaboration of practitioners and researchers from different disciplines such as medicine, paramedics, sociologist, statistician.
Geriatrics and Gerontology Research Group is particularly interested in the evaluation of the frail elderly person from interdisciplinary aspects in order to establish an individualized and integrated care plan. The general purpose of the COPE project (How to Care Older Patient at the Emergency Department?) is to improve the management of older patient admitted to emergency department suffering from chronic diseases and who need of a supportive care approach, especially by the promotion of Advanced Care Planning.
Population is ageing worldwide, leading to an increased number of older people suffering for one or more progressive chronic diseases, e.g. cardiovascular diseases, dementia, cancer, chronic respiratory diseases and diabetes. People suffering from progressive medical illnesses have a prolonged period of gradual decline and disability, but their pathway is typically unpredictable, with frequent exacerbations leading some of them to consult the emergency department (ED). The challenge is then to avoid unjustified therapeutic abstention as well as unnecessary therapy to the detriment of patient comfort. For some older patients (OP), life-prolonging treatments offered for acute conditions at ED may indeed not be of added-value in the trajectory of the illnesses. Moreover, they may not be in line with patients’ goals of care and preferences.
On the other hand, symptoms-relief could not be achieved easily in community-settings for patients already benefiting from palliative care plan. The ED could thus be a pivotal platform to re-assess patients’ health trajectory and to manage such burdensome symptoms. The general purpose of the research is to improve the management of OP admitted to ED suffering from chronic diseases and who need a supportive care approach, especially by the promotion of Advanced Care Planning.
We aim at understanding if SPICT tool could help to detect older persons (≥75 years) suffering from chronic diseases admitted to the emergency department with a poor life expectancy and health deterioration.
We conducted a multicenter prospective cohort study. The research took place within 2 emergency department (ED). We included 352 patients admitted to the ED in order to test the accuracy of SPICT to predict 6 or 12-month mortality. Follow-up are ongoing.
The COPE project is realized with the support from fund Palliative care, King Baudouin Foundation, Belgium