The Improvement in the Clinical Management of Patients Undergoing Palliative Care After Training the Primary Care Team by a Specialized Team: A Systematic Review.
- 1Graduate Program in Health Sciences, Faculty of Medical Sciences of Santa Casa de São Paulo (PPGCS), São Paulo 01224-001, SP, Brazil.
- 2Human Movement and Rehabilitation Graduate Program, Evangelical University of Goiás (UniEVANGÉLICA), Anápolis 75083-515, GO, Brazil.
- 3Undergraduate Program in Physiotherapy, Evangelical University of Goiás (UniEVANGÉLICA), Anápolis 75083-515, GO, Brazil.
Abstract
Background: Primary Health Care plays an important role in the provision and coordination of palliative care in many healthcare contexts. Education and training of healthcare professionals are relevant strategies to support the delivery of quality palliative care. Objective: To evaluate whether training healthcare professionals working in Primary Health Care improves symptom assessment and clinical management of patients eligible for palliative care. Methodology: Systematic review conducted according to PRISMA 2020 guidelines, with a protocol registered on the PROSPERO platform under the number CRD420261370621. The eligibility criteria were structured according to the PICO approach: population composed of healthcare professionals working in primary care; educational interventions in palliative care; comparator without training or with different modalities; outcomes of symptom assessment and clinical control. The searches were conducted in seven databases: PubMed/MEDLINE, Embase, Web of Science, Scopus, Cochrane Library, SciELO, and LILACS. Results: Eight studies were included in the review, with varied designs: a pilot randomized clinical trial, a quasi-experimental study, two evaluations of educational programs, a feasibility study, a retrospective population cohort, and two qualitative approaches. The findings revealed a generalist predominance in the provision of palliative care: 95% of the care was provided by generalists, 53% of patients did not receive identifiable palliative care in the last year of life, and specialists were virtually nonexistent in rural areas, where family doctors were responsible for nearly all care. Conclusions: Training of primary care teams is necessary, but insufficient on its own. Although it improves the confidence and knowledge of professionals, there is no robust evidence that it sustainably transforms patient clinical outcomes. The problem is structural: there is a lack of adequate clinical time, compatible remuneration, integration with specialists, and support infrastructure. It is necessary to go beyond education and promote reforms in the healthcare system so that palliative care in primary care is effectively qualified.
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BibTeX
@article{vieira2026improvement,
title = {{The Improvement in the Clinical Management of Patients Undergoing Palliative Care After Training the Primary Care Team by a Specialized Team: A Systematic Review.}},
author = {Aila Davis Fanstone Pina Vieira and Deise Aparecida de A P Oliveira and Tamyris M F Sudré and Lucas Azevedo N de Carvalho and Gabriela E Nascimento and Keyci S Ito Tabata and Rodrigo F de Oliveira and Vera Lúcia Dos S Alves},
journal = {Medical sciences (Basel, Switzerland)},
year = {2026},
month = oct,
doi = {10.3390/medsci14060690},
url = {https://europepmc.org/article/MED/42930609},
note = {CC BY},
}
RIS
TY - JOUR
TI - The Improvement in the Clinical Management of Patients Undergoing Palliative Care After Training the Primary Care Team by a Specialized Team: A Systematic Review.
AU - Aila Davis Fanstone Pina Vieira
AU - Deise Aparecida de A P Oliveira
AU - Tamyris M F Sudré
AU - Lucas Azevedo N de Carvalho
AU - Gabriela E Nascimento
AU - Keyci S Ito Tabata
AU - Rodrigo F de Oliveira
AU - Vera Lúcia Dos S Alves
PY - 2026
DA - 2026/10/21
JO - Medical sciences (Basel, Switzerland)
DO - 10.3390/medsci14060690
UR - https://europepmc.org/article/MED/42930609
AB - Background: Primary Health Care plays an important role in the provision and coordination of palliative care in many healthcare contexts. Education and training of healthcare professionals are relevant strategies to support the delivery of quality palliative care. Objective: To evaluate whether training healthcare professionals working in Primary Health Care improves symptom assessment and clinical management of patients eligible for palliative care. Methodology: Systematic review conducted according to PRISMA 2020 guidelines, with a protocol registered on the PROSPERO platform under the number CRD420261370621. The eligibility criteria were structured according to the PICO approach: population composed of healthcare professionals working in primary care; educational interventions in palliative care; comparator without training or with different modalities; outcomes of symptom assessment and clinical control. The searches were conducted in seven databases: PubMed/MEDLINE, Embase, Web of Science, Scopus, Cochrane Library, SciELO, and LILACS. Results: Eight studies were included in the review, with varied designs: a pilot randomized clinical trial, a quasi-experimental study, two evaluations of educational programs, a feasibility study, a retrospective population cohort, and two qualitative approaches. The findings revealed a generalist predominance in the provision of palliative care: 95% of the care was provided by generalists, 53% of patients did not receive identifiable palliative care in the last year of life, and specialists were virtually nonexistent in rural areas, where family doctors were responsible for nearly all care. Conclusions: Training of primary care teams is necessary, but insufficient on its own. Although it improves the confidence and knowledge of professionals, there is no robust evidence that it sustainably transforms patient clinical outcomes. The problem is structural: there is a lack of adequate clinical time, compatible remuneration, integration with specialists, and support infrastructure. It is necessary to go beyond education and promote reforms in the healthcare system so that palliative care in primary care is effectively qualified.
SN - 2076-3271
ER -