Deaths in general practice: an Irish national profile

Riain, Ailís Ní; Langton, Deirdre; Loughrey, Emer; Bury, Gerard

doi:10.1007/bf03173888

Cited by 2 publications

(7 citation statements)

References 3 publications

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“…Nine articles (two qualitative studies, five cross-sectional surveys, one mixed methods, one quasi-experimental trial) discussed availability of GP services. Studies were conducted in Canada,29 Italy,28 UK,41–43 the Netherlands26 44 and Australia 32 45…”

Section: Resultsmentioning

confidence: 99%

“…GPs provided PC in a variety of forms: clinic, home visits, phone support, case conferencing with specialists and out-of-hours support 32 43. In Ireland, GPs provided a mean of 5.4 home visits, 1.8 clinic visits and 3.6 episodes of phone support per deceased individual in the final 3 months of life 43…”

Section: Resultsmentioning

confidence: 99%

“…In Ireland, GPs provided a mean of 5.4 home visits, 1.8 clinic visits, and 3.6 episodes of phone support per deceased individual in the final three months of life. 43 Patients found phone support from GPs particularly beneficial, 29 reducing anxiety and allowing them to address medical issues proactively. 28 29 There were limits to that availability, with less availability on weekends, particularly overnight.…”

Section: Access To the Gp Home Visits And Out-of-hours Servicesmentioning

confidence: 99%

“…• Common in care of palliative care patients 43 45 • Provision made difficult by vague and inadequate clinical notes and management plans 43 45 • Availability of quality clinical notes reduced hospitalization 45 • After hours doctors often lacked knowledge of local services, availability of palliative care specialist advice, or how to administer palliative care medications. 43 . • GPs co-ordinate tasks in EoLC, but may delegate coordination to other professionals, but some GPs dispute whether it is their role to co-ordinate 26 • For cancer patients, co-ordination can be segmented between specialist services and the GP 30 • In Belgium, GPs coordinate palliative home care teams, which reduces GP workload, useful in complex cases.…”

Section: Out-of-hours Gp Servicesmentioning

confidence: 99%

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General practice physicians’ and nurses’ self-reported multidisciplinary end-of-life care: a systematic review

Senior

Grant

Rhee

et al. 2019

BMJ Support Palliat Care

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BackgroundGeneral 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.ObjectiveTo 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.MethodSystematic literature review. Data included papers (2000 to 2017) sought from Medline, Psychinfo, Embase, Joanna Briggs Institute and Cochrane databases.ResultsFrom 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.ConclusionsGPs 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.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Access To the Gp Home Visits And Out-of-hours Servicesmentioning

confidence: 99%

Section: Out-of-hours Gp Servicesmentioning

confidence: 99%

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General practice physicians’ and nurses’ self-reported multidisciplinary end-of-life care: a systematic review

Senior

Grant

Rhee

et al. 2019

BMJ Support Palliat Care

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“…37 Information obtained from collection of information about deaths had been used to help practices understand the healthcare needs of their practice populations and enable comparisons between practices. 38 One team reported use of the information to investigate nursing involvement in terminal care at home, 39 three others to investigate place of death, [40][41][42] three more potentially preventable deaths, [43][44][45] and others age at death and smoking 46 and referrals for autopsy. 47 In another practice, information was sought about the involvement of the general practitioner in the care of patients before death.…”

Section: Resultsmentioning

confidence: 99%

Making use of mortality data to improve quality and safety in general practice: a review of current approaches

Baker

Sullivan

Camosso‐Stefinovic

et al. 2007

Quality and Safety in Health Care

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Objective: To review studies of the use of mortality data in quality and safety improvement in general practice. Design: Narrative review. Methods: Search of Medline, Embase and CINAHL for articles reporting mortality monitoring or mortality reviews in general practice. The included articles were reported in English and of any study design, excluding case reports and comment pieces. Studies of palliative care and bereavement, and of primary care programmes in developing countries, were excluded. Results: 229 articles were identified in the searches, 65 were identified as potentially relevant and 53 were included in the review. The studies addressed the impact of primary care provision on mortality rates, methods of monitoring mortality, and the role of audit and death registers in quality and safety improvement. General practitioners were interested in using mortality data but reported difficulties in obtaining complete information. There were no experimental studies of the impact of the use of mortality data, and little evidence of long-term systematic initiatives to use mortality data in quality and safety improvement in general practice. Conclusions: Mortality data are not used systematically in general practice although general practitioners appear interested in the potential of this information in improving quality and safety. Improved systems to provide complete data are needed and experimental studies required to determine the effectiveness of use of the data to improve general practice care.

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Deaths in general practice: an Irish national profile

Abstract: GPs are notified rapidly of deaths in all groups and causes. In the majority, the GP has had recent clinical contact and has often been heavily involved in care. Most deaths and care occur outside the cancer-related sphere.

Cited by 2 publications

References 3 publications

General practice physicians’ and nurses’ self-reported multidisciplinary end-of-life care: a systematic review

General practice physicians’ and nurses’ self-reported multidisciplinary end-of-life care: a systematic review

Making use of mortality data to improve quality and safety in general practice: a review of current approaches

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