General practice palliative care: Patient and carer expectations, advance care plans and place of death - A systematic review

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

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

Background: 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. Objective: 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. Method: Systematic literature review. Data sources: Papers from 2000 to 2017 were sought from Medline, Psychinfo, Embase, Joanna Briggs Institute and Cochrane databases. Results: 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. Conclusions: 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.

Original languageEnglish
JournalBMJ Supportive and Palliative Care
DOIs
Publication statusAccepted/In press - 25 Jul 2018

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Palliative Care
General Practice
General Practitioners
Caregivers
Advance Care Planning
Nurses
Terminal Care
Information Storage and Retrieval
Primary Health Care
Databases
Population

Cite this

Johnson, Claire E. ; McVey, Peta ; Rhee, Joel Jin On ; Senior, Hugh ; Monterosso, Leanne ; Williams, Briony ; Fallon-Ferguson, Julia ; Grant, Matthew ; Nwachukwu, Harriet ; Aubin, Michèle ; Yates, Patsy ; Mitchell, Geoffrey. / General practice palliative care : Patient and carer expectations, advance care plans and place of death - A systematic review. In: BMJ Supportive and Palliative Care. 2018.
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abstract = "Background: 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. Objective: 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. Method: Systematic literature review. Data sources: Papers from 2000 to 2017 were sought from Medline, Psychinfo, Embase, Joanna Briggs Institute and Cochrane databases. Results: 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. Conclusions: 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.",
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Johnson, CE, McVey, P, Rhee, JJO, Senior, H, Monterosso, L, Williams, B, Fallon-Ferguson, J, Grant, M, Nwachukwu, H, Aubin, M, Yates, P & Mitchell, G 2018, 'General practice palliative care: Patient and carer expectations, advance care plans and place of death - A systematic review' BMJ Supportive and Palliative Care. https://doi.org/10.1136/bmjspcare-2018-001549

General practice palliative care : Patient and carer expectations, advance care plans and place of death - A systematic review. / Johnson, Claire E.; McVey, Peta; Rhee, Joel Jin On; Senior, Hugh; Monterosso, Leanne; Williams, Briony; Fallon-Ferguson, Julia; Grant, Matthew; Nwachukwu, Harriet; Aubin, Michèle; Yates, Patsy; Mitchell, Geoffrey.

In: BMJ Supportive and Palliative Care, 25.07.2018.

Research output: Contribution to journalReview article

TY - JOUR

T1 - General practice palliative care

T2 - Patient and carer expectations, advance care plans and place of death - A systematic review

AU - Johnson, Claire E.

AU - McVey, Peta

AU - Rhee, Joel Jin On

AU - Senior, Hugh

AU - Monterosso, Leanne

AU - Williams, Briony

AU - Fallon-Ferguson, Julia

AU - Grant, Matthew

AU - Nwachukwu, Harriet

AU - Aubin, Michèle

AU - Yates, Patsy

AU - Mitchell, Geoffrey

PY - 2018/7/25

Y1 - 2018/7/25

N2 - Background: 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. Objective: 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. Method: Systematic literature review. Data sources: Papers from 2000 to 2017 were sought from Medline, Psychinfo, Embase, Joanna Briggs Institute and Cochrane databases. Results: 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. Conclusions: 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.

AB - Background: 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. Objective: 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. Method: Systematic literature review. Data sources: Papers from 2000 to 2017 were sought from Medline, Psychinfo, Embase, Joanna Briggs Institute and Cochrane databases. Results: 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. Conclusions: 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.

KW - advance care planning

KW - consumer expectations

KW - general practice

KW - place of death

KW - primary palliative care

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DO - 10.1136/bmjspcare-2018-001549

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SN - 2045-435X

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