Background With an increasing ageing population in most countries, the role of general practitioners (GPs) and general practice nurses (GPNs) in providing optimal end of life (EoL) care is increasingly important.
Objective To explore: (1) patient and carer expectations of the role of GPs and GPNs at EoL; (2) GPs’ and GPNs’ contribution to advance care planning (ACP) and (3) if primary care involvement allows people to die in the place of preference.
Method Systematic literature review. Data sources: Papers from 2000 to 2017 were sought from Medline, Psychinfo, Embase, Joanna Briggs Institute and Cochrane databases.
Results From 6209 journal articles, 51 papers were relevant. Patients and carers expect their GPs to be competent in all aspects of palliative care. They valued easy access to their GP, a multidisciplinary approach to care and well-coordinated and informed care. They also wanted their care team to communicate openly, honestly and empathically, particularly as the patient deteriorated. ACP and the involvement of GPs were important factors which contributed to patients being cared for and dying in their preferred place. There was no reference to GPNs in any paper identified.
Conclusions Patients and carers prefer a holistic approach to care. This review shows that GPs have an important role in ACP and that their involvement facilitates dying in the place of preference. Proactive identification of people approaching EoL is likely to improve all aspects of care, including planning and communicating about EoL. More work outlining the role of GPNs in end of life care is required.
- primary palliative care
- general practice
- consumer expectations
- advance care planning
- place of death
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Supplementary files can be viewed at: http://dx.doi.org/10.1136/bmjspcare-2018-001549.
Acknowledgements We would like to acknowledge generous research support from the Primary Care Collaborative Cancer Clinical Trials Group, which is funded by Cancer Australia. Dr May-Lill Johansen joined the group in 2016 as part of her sabbatical leave and her input has been invaluable. Professor Elizabeth Halcomb provided valuable advice on the discussion on the development of the role of practice nurses in end of life care.
Correction notice This article has been updated since it was first published. The article type has been changed to Systematic review.
Contributors All authors contributed equally to this work.
Funding This paper was funded by Royal Australian College of General Practitioner/HCF grant in 2013.
Competing interests None declared.
Patient consent Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement The full protocol and dataset can be obtained on reasonable request from the corresponding author.
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