Building capacity for palliative care delivery in primary care settings: Mixed-methods evaluation of the INTEGRATE Project

This paper evaluates the INTEGRATE project – a 3-year pilot project conducted across 4 primary care practices in Ontario. The INTEGRATE model consisted of 2 interventions: interprofessional palliative care education and an integrated care model to facilitate early identification of patients with palliative care needs, early linkages to community-based resources, and improved communication between providers involved in patient care. A mixed-methods evaluation incorporating descriptive data, provider surveys before and after implementation, and interviews was used. All providers from each practice was invited to participate. A total of 294 patients were identified for early initiation of palliative care. Results demonstrated improvement in provider confidence to deliver palliative care (30% mean increase) and self-reported use of palliative care tools and services (25% mean increase). A standardised model for the early introduction of palliative care to patients can be integrated into the routine practice of primary care practitioners with appropriate training and support. Additional research is needed to understand the practice factors that contribute to the success of palliative care interventions in primary care and to examine patient outcomes.