Information transfer to out-of-hours co-operatives: a survey of general practitioners’ views in relation to palliative patients

Background In Ireland, weekend and night medical cover for community based patients is largely provided by general practice co-operatives. Doctors working in this service do not have direct access to patients’ medical records which challenges continuity of care.

Objectives This study investigates the opinion of general practitioners (GPs) on the potential value of a formalised method of information transfer regarding their palliative patients to out-of-hours GP co-operatives. The survey was designed to identify the information that is necessary to offer appropriate anticipated end-of-life care.

Methods A questionnaire was sent to all 414 GPs registered in the Irish Medical Directory in the southwest of Ireland. Data were analysed with Microsoft Excel and SPSS V.12.0.

Results 52% response rate with exclusion of incomplete questionnaires allowed analysis of 212 data sets. Currently, 82% of GPs do not routinely transfer information pertaining to end-of-life issues to the out-of-hours service. Despite this, 96% would value a standardised way of transferring information. 67% felt they sometimes refer unnecessarily to hospital emergency departments due to lack of information. The most important items of information identified by study participants are as follows:

▸ Diagnosis (97%)

▸ Medications (94%)

▸ Patient insight (91%)

▸ Patient wishes regarding end-of-life care (90%)

▸ Anticipated problems and suggested management (90%).

Conclusions A structured format for information transfer regarding end-of-life care is deemed important by GPs when working on-call at night and weekends. Diagnosis, patient preference and management plans are valued.