The role of the GP in palliative care

The role of the GP in palliative care Results from a mixed method study Mette Asbjørn Neergaard GP, Ph. D-student Research Unit for General Practice Aarhus University

Palliative care in primary care

Focus group interview study: Bereaved relative: "You see, at first, when we were told by the hospital physician that there was nothing more to do but control the pain, at that time, I felt left alone. . . We were simply left in limbo. "

Focus group interview study: Bereaved relative: "Well, I think the GP should have the opportunity to be in charge of the coordination. . . "

Focus group interview study: Bereaved relative: “In the last days before death – during Christmas and New Year – our GP was at our house at least once a day, most days, twice. We got his private mobile phone number and he told us not to contact a doctor from the emergency service – that was not necessary, he said, cause he was there…”

Focus group interview study: Bereaved relative: ". . . when the GP cannot manage, he should refer to someone who can. Our GP is the kind of person who thinks he knows best. "

Focus group interview study: GP: ”I believe we have a much more natural and central part to play. If we have known the patient for many years, I believe it’s absolutely natural that we assume the responsibility”

Focus group interview study: Hospital Consultant: ”When we have discharged a patient, we actually expect the GP to take charge. We should approach patients and ask about their relation to their GP as he or she becomes a central figure. You need to be realistic in secondary health-care – well, we can’t be there for the patients like the GP can. ”

Questionnaire / register study • 233 (70%) out of 333 responding GPs answered that they should be the co -ordinator in palliative care pathways

Questionnaire / register study Who ought to be the co-ordinator in the palliative pathway? Who was the co-ordinator in the palliative pathway? The GP 24 % 8% The community nurse 21% 23 % The palliative specialist team 14% 8% Your self 29 % 42 %

Conclusion • In many cases, the relatives want the GP to have a major role in the palliative pathways • Most GPs (and other health care professionals) want GPs to have a major role • The GPs does not always seem to fullfill this role acording to the bereaved relatives Thank you for your attention