PP-6 Barriers, enablers and optimal strategies for implementing a home-based palliative care: a Portuguese case study

<h3>Introduction</h3> Incorporating a Palliative Care (PC) approach into primary health care is a promising evidence-based practice. However, this practice has not been extensively integrated into primary care settings. While the Portuguese PC model highlights the principles of accessibility and fairness, a need for their expansion has become apparent, especially in the realm of home-based palliative intervention. <h3>Aims</h3> This qualitative study aims to identify barriers, enablers and optimal strategies for informing the implementation of a home-based PC intervention at Viseu, Portugal. <h3>Methods</h3> A brainstorming procedure was employed to query a group of ten PC professionals about the current practices for delivering PC, along with barriers, enablers and optimal strategies for implementing home-based PC. Data were examined using content analysis. <h3>Results</h3> Some barriers to PC delivery, included: i) precarious working hours for professionals; ii) lack of human resources, which leads to more complex management; iii) care overload inherent to other areas of professional activity (psychology and social service); iv) information systems not suitable for PC practice, which makes it difficult to access quality indicators; and v) transportation challenges to access care. Some enablers were also identified, including the availability of existing PC infrastructure, a clear definition of roles and interdisciplinary work, motivated PC professionals and a family support system. We also found recommendations linked to team composition, the degree of prioritization of patients accompanied, and the support offered by involved organizations. <h3>Conclusion</h3> Our findings underscore the significance of collaborative teams at the practice level in overcoming obstacles to effective implementation. Besides can benefit models of care that seek to optimize the relationship between primary care, specialized PC resources and community resources. <h3>Impact</h3> Recognizing obstacles to implementation may serve as a measure of enhanced preparedness. Only a coordinated implementation of home-based PC will ensure quality standards of equitable palliative and end-of-life care for all.