Trial Information

A Shared Care Approach for Seriously Ill Cancer Patients Between General Practice, Discharge Department and a Specialist Palliative Care Team

The intervention in the study is of organisational character. The patients will be
randomised into two groups (groups B and C). A group of usual care patients will be included
primary to the intervention (group A). The groups are:

A. Usual discharge with regular discharge letter to the GP. The GP, together with the
community nurse, is responsible for the palliative care, including referral to a specialist
palliative care team, hospice, hospital, etc., if necessary

B. Discharge with referral to a specialist palliative care team. This is a patient-centred
shared care model in which the palliative team helps to organise the patient's treatment and
care

C. Discharge with extra effort put into improving the communication between the hospital and
the GP. The GP will receive a phone call from the doctor who is discharging the patient, a
detailed discharge letter, written information about the patient's type of cancer and acute
oncological symptoms, name and phone number of the community nurse and name and phone number
of a specialist in palliative medicine, who can be contacted for advice. This is a shared
care model, where focus is on supporting the health care professionals.