Title |
General practice palliative care: patient and carer expectations, advance care plans and place of death—a systematic review
|
---|---|
Published in |
BMJ Supportive & Palliative Care , July 2018
|
DOI | 10.1136/bmjspcare-2018-001549 |
Pubmed ID | |
Authors |
Claire E Johnson, Peta McVey, Joel Jin-On Rhee, Hugh Senior, Leanne Monterosso, Briony Williams, Julia Fallon-Ferguson, Matthew Grant, Harriet Nwachukwu, Michèle Aubin, Patsy Yates, Geoffrey Mitchell |
Abstract |
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. 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. Systematic literature review. Papers from 2000 to 2017 were sought from Medline, Psychinfo, Embase, Joanna Briggs Institute and Cochrane databases. 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. 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. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
Australia | 17 | 30% |
Spain | 6 | 11% |
United Kingdom | 5 | 9% |
Canada | 2 | 4% |
Indonesia | 1 | 2% |
Mexico | 1 | 2% |
United States | 1 | 2% |
Argentina | 1 | 2% |
France | 1 | 2% |
Other | 0 | 0% |
Unknown | 21 | 38% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 36 | 64% |
Scientists | 10 | 18% |
Practitioners (doctors, other healthcare professionals) | 10 | 18% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 73 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Ph. D. Student | 9 | 12% |
Student > Master | 9 | 12% |
Researcher | 8 | 11% |
Other | 7 | 10% |
Student > Bachelor | 6 | 8% |
Other | 10 | 14% |
Unknown | 24 | 33% |
Readers by discipline | Count | As % |
---|---|---|
Nursing and Health Professions | 19 | 26% |
Medicine and Dentistry | 14 | 19% |
Social Sciences | 5 | 7% |
Psychology | 3 | 4% |
Engineering | 2 | 3% |
Other | 4 | 5% |
Unknown | 26 | 36% |