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Trial registered on ANZCTR
Registration number
ACTRN12613001377729
Ethics application status
Approved
Date submitted
10/12/2013
Date registered
16/12/2013
Date last updated
16/12/2013
Type of registration
Retrospectively registered
Titles & IDs
Public title
Case conferences between general practitioners and specialist teams to plan end of life care of people with end stage heart failure and lung disease: Pilot study
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Scientific title
Do case conferences between general practitioners and specialist teams improve outcomes and service utilisation in people with life limiting heart and lung disease compared to usual care?
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Secondary ID [1]
283742
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nil
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Universal Trial Number (UTN)
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Trial acronym
BASIC-PC (Better Assessment, Support and Interdisciplinary Collaboration - Palliative Care)
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
heart failure
290706
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end stage lung disease
290707
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end of life care
290708
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Condition category
Condition code
Cardiovascular
291076
291076
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0
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Other cardiovascular diseases
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Respiratory
291077
291077
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0
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Chronic obstructive pulmonary disease
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Public Health
291107
291107
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0
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Health service research
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Single case conference of 30-40 minutes between General practitioner, palliative care physician and specialist nurse to develop a care plan for persons with life limiting heart or lung disease. Case conference provides a comprehensive review of the case from a palliative care perspective, including symptom control, psychosocial issues for patient and carer, advance care planning and service delivery, with an emphasis on care coordination between specialist and community based care.
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Intervention code [1]
288429
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Treatment: Other
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Comparator / control treatment
Normal care- specialist medical services focusing on maximising function, general practitioner providing day to day care but not in close liaison with specialists, and nurses providing case management at home, and palliative care not involved at all
Control data: Hospital and GP Records search for service utilisation. Time period is up to 12 months prior to the case conference, compared with up to twelve months, or to death, post case conference. Post case conference records searched for evidence of compliance with recommendations from case conference.
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Control group
Historical
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Outcomes
Primary outcome [1]
291065
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Annual rate of hospitalisations - a hospitalisation is any stay in hospital for one night or more, as assessed by the public health medical record
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Assessment method [1]
291065
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Timepoint [1]
291065
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12 months post case conference (or death).
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Secondary outcome [1]
305931
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Australia Modified Karnofsky Performance Scale
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Assessment method [1]
305931
0
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Timepoint [1]
305931
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one and three months
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Secondary outcome [2]
305932
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Palliative Outcomes Scale
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Assessment method [2]
305932
0
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Timepoint [2]
305932
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one and three months
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Secondary outcome [3]
305933
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Hospital Anxiety and Depression Scale ( ill person and primary carer)
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Assessment method [3]
305933
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Timepoint [3]
305933
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one and three months
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Secondary outcome [4]
305937
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Health related Quality of Life (SF12) ( ill person and primary carer)
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Assessment method [4]
305937
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Timepoint [4]
305937
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one and three months
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Secondary outcome [5]
305938
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Personal Costs of care - questionaire completed by patient and carer for personal costs incurred- eg visits to medical services, medications, medical supplies, work time lost. Cost estimate for the health services of providing care (eg cost per day of an admission, an ED visit, a home visit by the nurse), cost estimates for health service providers in preparing for and conducting the case conference and subsequent report.
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Assessment method [5]
305938
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Timepoint [5]
305938
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three months
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Secondary outcome [6]
305939
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Other service utilisation data - number ED visits, number of ED visits without admission, number of hospital admissions and average length of stay. Data derived from public health records. Calculated annual rates of these parameters.
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Assessment method [6]
305939
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Timepoint [6]
305939
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12 months or at death
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Secondary outcome [7]
305940
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Carer Support Needs Assessment Tool
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Assessment method [7]
305940
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Timepoint [7]
305940
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one and three months
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Secondary outcome [8]
305942
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Carer Strain Index
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Assessment method [8]
305942
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Timepoint [8]
305942
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one and three months
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Eligibility
Key inclusion criteria
persons identified by heart failure or lung health as being at risk of dying within 12 months
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Minimum age
18
Years
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Maximum age
105
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
high risk of death with three months
severe cognitive impairment
resident of a Residential Aged Care Facility
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Eligible persons identified by the heart failure or lung health team nurses using the surprise question ( Would I be surprised if this person died within 12 months?"
The nurse approaches the patient to gauge interest in conducting a case conference. If yes, they are given patient information sheet and consent form. The nurse completes consent process at their next visit. Details are then passed to the research team.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
not relevant for pilot -
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
This is a pilot to refine the case conference process and gather data to calculate sample size. A full RCT will be planned based on pilot data.
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
for non-normally distributed data:
Wilcoxon Rank sum test comparing health service utilisation data.
for normally distributed data
paired t tests for continuous data
Chi Square ( or Student) test for categorical data
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
30/11/2011
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Actual
15/12/2011
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Date of last participant enrolment
Anticipated
31/12/2013
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
40
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
1849
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Ipswich Hospital - Ipswich
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Funding & Sponsors
Funding source category [1]
288413
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Government body
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Name [1]
288413
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National Health and Medical Research Council
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Address [1]
288413
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16 Marcus Clarke Street,
Canberra, ACT, 2601
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Country [1]
288413
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Australia
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Primary sponsor type
University
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Name
University of Queensland
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Address
St Lucia
Queensland, 4072
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Country
Australia
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Secondary sponsor category [1]
287121
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None
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Name [1]
287121
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Address [1]
287121
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Country [1]
287121
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
290292
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West Moreton Human Ethics Review Committee
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Ethics committee address [1]
290292
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East St Ipswich, Queensland, 4305
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Ethics committee country [1]
290292
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Australia
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Date submitted for ethics approval [1]
290292
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Approval date [1]
290292
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11/11/2011
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Ethics approval number [1]
290292
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HREC/11/QWMS/36
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Summary
Brief summary
With the ageing of the population, the number of people entering the last stages of life will increase rapidly in the coming few years. Most people will die of progressive, non-malignant disease and most will never be reviewed by a specialist palliative care team, in spite of the intensity of many peoples' needs being equivalent to those dying of cancer. This study aims to improve the care of people dying of non-malignant disease, by conducting a case conference between the patient's GP, their specialist heart failure or lung health nurse, and a palliative care specialist. The purpose is to conduct a comprehensive case review, and develop a clear care plan with clear allocation of tasks. We will compare service utilisation after the conference with that of the previous 12 months, patient outcomes, carer outcomes, and a health economic analysis. This project is a pilot and will lead to a formal randomised controlled trial.
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Trial website
http://primarysecondarycre.com/
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Trial related presentations / publications
none to date
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Public notes
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Contacts
Principal investigator
Name
44890
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Prof Geoffrey Mitcehll
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Address
44890
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School of Medicine
University of Queensland Ipswich Campus
Salisbury Rd
Ipswich, 4305
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Country
44890
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Australia
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Phone
44890
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+61 7 3381 1363
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Fax
44890
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+61 7 3381 1356
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Email
44890
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[email protected]
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Contact person for public queries
Name
44891
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Geoffrey Mitchell
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Address
44891
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School of Medicine
University of Queensland Ipswich Campus
Salisbury Rd
Ipswich, 4305
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Country
44891
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Australia
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Phone
44891
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+617 3381 1363
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Fax
44891
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+61 7 3381 1356
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Email
44891
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[email protected]
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Contact person for scientific queries
Name
44892
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Geoffrey Mitchell
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Address
44892
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School of Medicine
University of Queensland Ipswich Campus
Salisbury Rd
Ipswich, 4305
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Country
44892
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Australia
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Phone
44892
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+61 7 3381 1363
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Fax
44892
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+61 7 3381 1356
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Email
44892
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Case conference primary-secondary care planning at end of life can reduce the cost of hospitalisations.
2016
https://dx.doi.org/10.1186/s12904-016-0157-9
N.B. These documents automatically identified may not have been verified by the study sponsor.
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