The Opportunities for Palliative care Access in non-cancer Life-limiting illness (OPAL) study is a CIHR-funded research program that aims to understand how a palliative approach is delivered across the healthcare system for patients with non-cancer life-limiting illness. By integrating qualitative and quantitative population-level data, the program examines how palliative care is conceptualized, measured, and implemented across primary and specialty care.
The first manuscript, led by Ashlinder Gill, examined how experts distinguished a palliative approach from routine care in chronic illness. Findings highlight definition inconsistencies and challenges in identifying measurable indicators of palliative approaches within health administrative data.
The second manuscript, led by Michelle Howard and currently in preparation for Journal of Pain and Symptom Management, describes physician palliative care billing patterns among patients who died of advanced COPD and heart failure. Early findings suggest that family physicians provide most direct palliative care, while specialists (e.g. cardiologists, respirologists) contribute primarily through case conferences and family discussions. These findings also highlight important limitations of relying on palliative designated billing codes alone to measure palliative care delivery.
A third manuscript for submission to CMAJ, led by Thilini Wijesekera, reports the association between length of the patient–family physician relationship and palliative care and end-of-life health care outcomes.
Lead: Michelle Howard Contact: Shuaib Hafid (hafids3@mcmaster.ca), Ashlinder Gill (gilla89@mcmaster.ca)
Research Project Update, VIP Lab
Research Project Update