Abstract:
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.
journal_name
BMJ Support Palliat Carejournal_title
BMJ supportive & palliative careauthors
Senior H,Grant M,Rhee JJ,Aubin M,McVey P,Johnson C,Monterosso L,Nwachukwu H,Fallon-Ferguson J,Yates P,Williams B,Mitchell Gdoi
10.1136/bmjspcare-2019-001852subject
Has Abstractpub_date
2019-08-29 00:00:00eissn
2045-435Xissn
2045-4368pii
bmjspcare-2019-001852pub_type
杂志文章abstract:OBJECTIVES:Loss of appetite is prevalent in palliative care and distressing for patients and families. Therapies include corticosteroids or progestogens. This study explores the net effect of dexamethasone on anorexia. METHODS:Prospective data were collected when dexamethasone was started for anorexia as part of routi...
journal_title:BMJ supportive & palliative care
pub_type: 杂志文章
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更新日期:2016-09-01 00:00:00
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journal_title:BMJ supportive & palliative care
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abstract:OBJECTIVE:Evidence is mixed regarding the impact of advance care planning (ACP) on place of death. This cohort study investigated the effect of ACP programmes on place of death and utilisation of life-sustaining treatments for patients during end-of-life (EOL) care. METHODS:This prospective cohort study identified dec...
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abstract:OBJECTIVES:This study aimed to identify gaps in palliative care (PC) provision across the National Cancer Grid (NCG) centres in India. METHODS:We performed a cross-sectional validated web-based survey on 102 NCG cancer centres (Nov '17 to April '18). The survey questionnaire had seven sections collecting data relating...
journal_title:BMJ supportive & palliative care
pub_type: 杂志文章
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abstract:BACKGROUND:The key challenge for most developed countries is meeting the needs of our ageing population, in particular, those nearing the end of their lives - population-based end-of-life care. Building on a public health approach to meet needs of an area-wide population, and a practical approach of enabling generalist...
journal_title:BMJ supportive & palliative care
pub_type: 杂志文章
doi:10.1136/bmjspcare-2015-000906.18
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVES:To identify those factors which adversely affected recruitment to a large multicentre palliative care study. METHODS:Patient accrual to a multicentre, observational, palliative care study was monitored at three critical junctures in the research process. (1) Eligibility-did the patient fulfil the study entr...
journal_title:BMJ supportive & palliative care
pub_type: 杂志文章,多中心研究
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更新日期:2013-09-01 00:00:00
abstract:OBJECTIVES:Prognostication is an essential ability to clinicians. Nevertheless, it has been shown to be quite variable in acutely ill patients, potentially leading to inappropriate care. We aimed to assess the accuracy of physician's prediction of hospital mortality in acutely deteriorating patients referred for urgent...
journal_title:BMJ supportive & palliative care
pub_type: 杂志文章
doi:10.1136/bmjspcare-2018-001567
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abstract:BACKGROUND:Pain control is an essential component of high-quality palliative care. Unfortunately, many low-income and middle-income countries lack an appropriate infrastructure to provide palliative care and suffer from a severe lack of access to opioid analgesics to alleviate pain from various conditions such as cance...
journal_title:BMJ supportive & palliative care
pub_type: 杂志文章
doi:10.1136/bmjspcare-2019-001871
更新日期:2019-10-30 00:00:00
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journal_title:BMJ supportive & palliative care
pub_type: 杂志文章
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abstract:OBJECTIVE:To develop and implement a methodology for capturing complete haematological malignancy pathway data and use it to identify variations in specialist palliative care (SPC) referrals. METHODS:In our established UK population-based patient cohort, 323 patients were diagnosed with acute myeloid leukaemia, diffus...
journal_title:BMJ supportive & palliative care
pub_type: 杂志文章
doi:10.1136/bmjspcare-2013-000578
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journal_title:BMJ supportive & palliative care
pub_type: 杂志文章
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更新日期:2020-11-18 00:00:00
abstract:BACKGROUND:Breast cancer is becoming the most common cancer among women of Indian origin. However, little is known about the psychological impact of the disease and its treatment among this population. AIM:To improve understanding of psychological symptoms among Indian women with breast cancer. DESIGN:This is a syste...
journal_title:BMJ supportive & palliative care
pub_type: 杂志文章,评审
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更新日期:2020-05-11 00:00:00
abstract:BACKGROUND:A diagnosis of cancer and anticipated death of a loved one has a significant impact on the whole family. Research has mainly focused on carers, with little emphasis on the wider, long-term implications. AIM:To explore the cancer beliefs of patients with advanced cancer and their relatives. The focus was on ...
journal_title:BMJ supportive & palliative care
pub_type: 杂志文章
doi:10.1136/bmjspcare-2015-000906.74
更新日期:2015-04-01 00:00:00
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journal_title:BMJ supportive & palliative care
pub_type: 杂志文章
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更新日期:2020-05-14 00:00:00
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journal_title:BMJ supportive & palliative care
pub_type: 杂志文章,评审
doi:10.1136/bmjspcare-2012-000253
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:In healthcare, many service evaluation questionnaires use free-text boxes without formal mechanisms for analysis. Patients and carers spend time documenting concerns that are often ignored or managed locally in an ad hoc manner. Currently, palliative care experiences of patients and carers in Wales are measu...
journal_title:BMJ supportive & palliative care
pub_type: 杂志文章
doi:10.1136/bmjspcare-2015-000920
更新日期:2019-03-01 00:00:00
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journal_title:BMJ supportive & palliative care
pub_type: 杂志文章,评审
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更新日期:2020-10-05 00:00:00
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journal_title:BMJ supportive & palliative care
pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:2018-03-01 00:00:00
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journal_title:BMJ supportive & palliative care
pub_type: 杂志文章,随机对照试验
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更新日期:2020-03-01 00:00:00
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journal_title:BMJ supportive & palliative care
pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章
doi:10.1136/bmjspcare-2015-001001
更新日期:2019-03-01 00:00:00
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journal_title:BMJ supportive & palliative care
pub_type: 杂志文章,评审
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更新日期:2021-01-04 00:00:00
abstract:OBJECTIVES:Clinicians report that withdrawal of mechanical ventilation in motor neuron disease is challenging. We report on the evaluation of the process and outcomes called for by the Association for Palliative Medicine of Great Britain and Ireland (APM) guidance. METHODS:Excel analysis of a core data set, defined in...
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pub_type: 杂志文章
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