Article Text

PDF
General practitioners (GPs) and end-of-life care: a qualitative study of Australian GPs and specialist palliative care clinicians
  1. Joel J Rhee1,2,3,
  2. Patrick C K Teo2,
  3. Geoffrey K Mitchell4,
  4. Hugh E Senior4,5,
  5. Aaron J H Tan2 and
  6. Josephine M Clayton3,6
  1. 1 School of Medicine, University of Wollongong, Wollongong, Australia
  2. 2 School of Public Health and Community Medicine, UNSW, Sydney, New South Wales, Australia
  3. 3 HammondCare, Sydney, New South Wales, Australia
  4. 4 Primary Care Clinical Unit, Faculty of Medicine, University of Queensland, Brisbane, Australia
  5. 5 College of Health, Massey University, Wellington, New Zealand
  6. 6 Northern Clinical School, Faculty of Medicine, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to Dr Joel J Rhee, School of Medicine, University of Wollongong, Wollongong, NSW 2522, Australia; jrhee{at}uow.edu.au

Abstract

Objectives General practitioners (GPs) are well placed to be involved in end-of-life care for patients with life-limiting illnesses. However, differing views exist regarding their role. This study aims to explore the views of GPs and specialist palliative care clinicians (SPCCs) on the role that GPs should play in the planning and provision of end-of-life care and important barriers and facilitators to GPs’ involvement in end-of-life care including suggestions for improvement.

Methods Qualitative description methodology using semistructured interviews of 11 GPs and 10 SPCCs.

Results The participants identified two key roles that GPs should play in the planning and provision of end-of-life care: care planning and referring to palliative care services and being the primary clinician in charge of patient care. GPs and SPCCs expressed similar views; however, a significant proportion of the GP participants were not actively involved in end-of-life care. Factors affecting GPs’ involvement in end-of-life care included: (1) GP and practice factors including continuity of care, long-term relationships with patients, knowledge and skills in end-of-life care, resource limitations and work patterns; (2) communication and collaboration between GPs and the acute healthcare system and (3) communication and collaboration between GPs and SPCCs.

Conclusion GPs have a key role in the planning and provision of end-of-life care. GPs could be encouraged in this role by providing them with education and practical experience in end-of-life care, making changes to remuneration structure, formalised arrangements for shared care and encouraging continuity of care and developing long-term relationship with their patients.

  • primary palliative care
  • general practice
  • multi-disciplinary team

Statistics from Altmetric.com

Footnotes

  • Contributors JR, GM, HS and JC planned the study. PT, AT and JR conducted the interviews. JR was the primary coder of all the interviews. AT, PT, JC and HS coded one-third of the interviews and participated in coding and analysis meetings with JR. JR and PT conducted additional analysis following peer reviewer feedback. All investigators contributed to the writing of the manuscript and reviewed and approved the final version. JR submitted the study.

  • Funding The study was funded by a research grant from the Royal Australian College of General Practitioners (RACGP) and the Primary Care Collaborative Cancer Clinical Trials Group (PC4).

  • Competing interests JR has provided consultancy advice to Teva Pharma Australia and has received consultancy honoraria.

  • Patient consent Not required.

  • Ethics approval The project was approved by Human Research Ethics Committees of UNSW (HC12553) and the University of Queensland (2012001275).

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data sharing statement No additional data are available.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.