RT Journal Article SR Electronic T1 Systematic review of general practice end-of-life symptom control JF BMJ Supportive & Palliative Care JO BMJ Support Palliat Care FD British Medical Journal Publishing Group SP 411 OP 420 DO 10.1136/bmjspcare-2017-001374 VO 8 IS 4 A1 Geoffrey K Mitchell A1 Hugh E Senior A1 Claire E Johnson A1 Julia Fallon-Ferguson A1 Briony Williams A1 Leanne Monterosso A1 Joel J Rhee A1 Peta McVey A1 Matthew P Grant A1 Michèle Aubin A1 Harriet TG Nwachukwu A1 Patsy M Yates YR 2018 UL http://spcare.bmj.com/content/8/4/411.abstract AB Background End of life care (EoLC) is a fundamental role of general practice, which will become more important as the population ages. It is essential that general practice’s role and performance of at the end of life is understood in order to maximise the skills of the entire workforce.Objective To provide a comprehensive description of the role and performance of general practitioners (GPs) and general practice nurses (GPNs) in EoLC symptom control.Method Systematic literature review of papers from 2000 to 2017 were sought from Medline, PsycINFO, Embase, Joanna Briggs Institute and Cochrane databases.Results From 6209 journal articles, 46 papers reported GP performance in symptom management. There was no reference to the performance of GPNs in any paper identified. Most GPs expressed confidence in identifying EoLC symptoms. However, they reported lack of confidence in providing EoLC at the beginning of their careers, and improvements with time in practice. They perceived emotional support as being the most important aspect of EoLC that they provide, but there were barriers to its provision. GPs felt most comfortable treating pain, and least confident with dyspnoea and depression. Observed pain management was sometimes not optimal. More formal training, particularly in the use of opioids was considered important to improve management of both pain and dyspnoea.Conclusions It is essential that GPs receive regular education and training, and exposure to EoLC from an early stage in their careers to ensure skill and confidence. Research into the role of GPNs in symptom control needs to occur.