Palliative primary care – a Norwegian questionnaire study on General Practitioners’ role

Background

The aim of this study is to gain knowledge about the GP´s role in palliation in the community setting, in relation to the guidelines for palliative care.

Methods

The study is a questionnaire survey based on elements from the national guideline in palliation. Data was analyzed descriptively, using SPSS. The questionnaire was sent to all 246 GPs in one Norwegian county. Response rate was 57.7 percent. The main outcome measures were whether participants used tools depicted in the guideline and how they communicated with partners and regarded their own role in the palliative trajectory. There was a focus on participation in terminal care.

Results

GPs both saw few patients with palliative needs and felt challenged in maintaining their competence. Few used tools for symptom assessment, and aids for co-operation and advanced care plans were rarely used. The GPs had less communication with the specialist health service than with collaborative partners in the community. Half saw the GP as a key worker in palliative care, and half made themselves available outside office hours. One third had not taken part in terminal care within the last three years. A majority felt that their patients received adequate relief. Most GPs wanted more knowledge on the subject

Conclusions

GPs had varying experiences from palliative care. However, they experienced that patients received adequate care. Important elements in the guideline was not in use by many GPs, and they did not have a uniform view on their role in the palliative trajectory. Further research is needed to explore the reasons for this.

keywords: palliation; primary care; general practice; guideline; symptom assessment; advanced care planning