General practitioners (GPs) and end-of-life care: a qualitative study of Australian GPs and specialist palliative care clinicians.

Autor:	Rhee JJ; School of Medicine, University of Wollongong, Wollongong, Australia jrhee@uow.edu.au.; School of Public Health and Community Medicine, UNSW, Sydney, New South Wales, Australia.; HammondCare, Sydney, New South Wales, Australia., Teo PCK; School of Public Health and Community Medicine, UNSW, Sydney, New South Wales, Australia., Mitchell GK; Primary Care Clinical Unit, Faculty of Medicine, University of Queensland, Brisbane, Australia., Senior HE; Primary Care Clinical Unit, Faculty of Medicine, University of Queensland, Brisbane, Australia.; College of Health, Massey University, Wellington, New Zealand., Tan AJH; School of Public Health and Community Medicine, UNSW, Sydney, New South Wales, Australia., Clayton JM; HammondCare, Sydney, New South Wales, Australia.; Northern Clinical School, Faculty of Medicine, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia.
Jazyk:	angličtina
Zdroj:	BMJ supportive & palliative care [BMJ Support Palliat Care] 2018 Nov 01. Date of Electronic Publication: 2018 Nov 01.
DOI:	10.1136/bmjspcare-2018-001531
Abstrakt:	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. Competing Interests: Competing interests: JR has provided consultancy advice to Teva Pharma Australia and has received consultancy honoraria. (© Author(s) (or their employer(s)) 2018. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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