General practice nurses and physicians and end of life: A systematic review of models of care

Geoffrey Mitchell, Michèle Aubin, Hugh Senior, Claire Johnson, Julia Fallon-Ferguson, Briony Williams, Leanne Monterosso, Joel J. Rhee, Peta McVey, Matthew Grant, Harriet Nwachukwu, Patsy Yates

Research output: Contribution to journalReview articlepeer-review

7 Citations (Scopus)

Abstract

Background: General practitioners (GPs) and general practice nurses (GPNs) face increasing demands to provide palliative care (PC) or end-of-life care (EoLC) as the population ages. In order to maximise the impact of GPs and GPNs, the impact of different models of care that have been developed to support their practice of EoLC needs to be understood. Objective: To examine published models of EoLC that incorporate or support GP and GPN practice, and their impact on patients, families and the health system. 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, 13 papers reported models of care supporting the GP and GPN's role in EoLC or PC practice. Services and guidelines for clinical issues have mixed impact on improving symptoms, but improved adherence to clinical guidelines. National Frameworks facilitated patients being able to die in their preferred place. A single specialist PC-GP case conference reduced hospitalisations, better maintained functional capacity and improved quality of life parameters in both patients with cancer and without cancer. No studies examined models of care aimed at supporting GPNs. Conclusions: Primary care practitioners have a natural role to play in EoLC, and most patient and health system outcomes are substantially improved with their involvement. Successful integrative models need to be tested, particularly in non-malignant diseases. Such models need to be explored further. More work is required on the role of GPNs and how to support them in this role.

Original languageEnglish
Pages (from-to)E23-E29
JournalBMJ Supportive and Palliative Care
Volume14
Issue numbere1
Early online date27 Jul 2020
DOIs
Publication statusPublished - 1 May 2024

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