Case conferences in palliative care: a substudy of a cluster randomised controlled trial

Background: In palliative care, case conferences have demonstrated improved maintenance of function and a significant reduction in hospitalisations. This study aimed to define the content and themes of palliative care case conferences. Methods: This was a substudy of a cluster randomised controlled trial. Case conferences meeting the requirements for Medicare Benefits Schedule reimbursement were organised by the research officer in conjunction with the general practitioner and the participating palliative care service. All were audiotaped, coded and analysed for content and themes, using qualitative methods and interaction analysis. Results: Seventeen case conferences were transcribed and coded. Physical issues were the dominant topic. Management of psychosocial concerns were rarely discussed. Lack of information was a common theme and time was spent during each conference ensuring all people were familiar with the issues and patient history. Healthcare professionals tended to respond to the content of patient concerns, but not the emotion. Discussion: The discussions were complex and health professional participants rarely summarised information or checked that patients and carers had understood the information provided.