Interprofessional KOPAL case conferences on patients with non-oncological palliative care needs – a qualitative analysis of interaction

In Germany, patients with chronic non-malignant diseases (CNMD) are predominantly treated by general practitioners (GPs). Yet, little is known about communication between GPs and specialist palliative home care (SPHC) teams in terms of care needs and care planning for patients. Our analysis therefore aims at GPs´, SPHC nurses’ and SPHC physician’s interaction during case conferences (CCs) on patients with CNMD following an initial comprehensive palliative care consultation. A total of 78 CCs were conducted between January 2020 and March 2021 by telephone and recorded by non-participating observers using pre-categorized protocol forms. Content, course and patterns of communication of the participating 25 GPs, 16 SPHC nurses and 11 SPHC physicians are investigated by secondary document analysis with methodical reference to Kuckartz’s structuring content analysis. CCs were characterized by a cooperative and welcoming atmosphere, focussing on the patient’s situation. CCs were mainly started and facilitated by the SPHC nurses. Most GPs showed great interest in nurses’ narrations and suggestions for improvement. GPs received important new information about their patients in some CCs. SPHC physicians mainly addressed medication regimens and emergency prevention. CCs’ participants interacted constructively in a positive atmosphere on an equal level. SPHC nurses hold a central role. We conclude that interprofessional CCs might support the improvement of health care of chronically ill patients by common reflection and the development of therapy goals and care plans. Increased structuring of CCs might trigger more specific treatment plans. KOPAL is registered on the German clinical trial register “Deutsches Register Klinischer Studien (DRKS)” (registration number DRKS00017795 17 November 2021, V.05).