PT - JOURNAL ARTICLE AU - Hugh Senior AU - Matthew Grant AU - Joel J Rhee AU - Michèle Aubin AU - Peta McVey AU - Claire Johnson AU - Leanne Monterosso AU - Harriet Nwachukwu AU - Julia Fallon-Ferguson AU - Patsy Yates AU - Briony Williams AU - Geoffrey Mitchell TI - General practice physicians’ and nurses’ self-reported multidisciplinary end-of-life care: a systematic review AID - 10.1136/bmjspcare-2019-001852 DP - 2019 Aug 29 TA - BMJ Supportive & Palliative Care PG - bmjspcare-2019-001852 4099 - http://spcare.bmj.com/content/early/2019/08/29/bmjspcare-2019-001852.short 4100 - http://spcare.bmj.com/content/early/2019/08/29/bmjspcare-2019-001852.full AB - Background General practitioners (GPs) and general practice nurses (GPNs) face increasing demands to provide end-of-life care (EoLC) as the population ages. To enhance primary palliative care (PC), the care they provide needs to be understood to inform best practice models of care.Objective To provide a comprehensive description of the self-reported role and performance of GPs and GPNs in (1) specific medical/nursing roles, (2) communication, (3) care co-ordination, (4) access and out-of-hours care, and (5) multidisciplinary care.Method Systematic literature review. Data included papers (2000 to 2017) sought from Medline, Psychinfo, Embase, Joanna Briggs Institute and Cochrane databases.Results From 6209 journal articles, 29 reviewed papers reported the GPs’ and GPNs’ role in EoLC or PC practice. GPs report a central role in symptom management, treatment withdrawal, non-malignant disease management and terminal sedation. Information provision included breaking bad news, prognosis and place of death. Psychosocial concerns were often addressed. Quality of communication depended on GP–patient relationships and GP skills. Challenges were unrealistic patient and family expectations, family conflict and lack of advance care planning. GPs often delayed end-of-life discussions until 3 months before death. Home visits were common, but less so for urban, female and part-time GPs. GPs co-ordinated care with secondary care, but in some cases parallel care occurred. Trust in, and availability of, the GP was critical for shared care. There was minimal reference to GPNs’ roles.Conclusions GPs play a critical role in palliative care. More work is required on the role of GPNs, case finding and models to promote shared care, home visits and out-of-hours services.