Improvement of home-based palliative care: A French multicentre study

Context.- Deciding to die at home is a complex decision involving many care providers. In line with the new French palliative care strategy, focusing on the expansion of the home-based palliative care, home-based palliative care teams (HPCTs) tries to improve support for professionals and family caregivers. The aim of this study is to characterize the benefits of three French HPCTs from Auvergne-Rhone-Alpes area on patients receiving palliative care without home hospitalisation. Methods. - This preliminary and observational study is based on qualitative analysis of the initiatives and measures provided by 3 HPCTs. Results. - Of all medical activity, home-based care represents 14 % and 25 % of two HPCTs. The third one, entirely dedicated to home-based care, provided 313 clinical consultations in 2016. Considering activity reports, HPCTs are involved in the healthcare network to solve ethical issues, treat pain or discomfort, support patients and caregivers, assess and coordinate the multidisciplinary management of these patients. Conclusion. - HPCTs are crucial to coordinate multiple and motivated actors. Providing a bridge between home-based and hospital care, HPCTs try to respect the family privacy, patient choices and the professionalism of carers. This assumes complex and multidisciplinary consultations, requiring experienced players and availability. (C) 2018 Elsevier Masson SAS. All rights reserved.