General Practitioners involvement in enteral tube feeding at home: a qualitative study

Abstract

BackgroundComplex medical treatment is moving from hospital to primary care and General Practitioners (GPs) are increasingly asked to undertake new roles. There are now an estimated 19,500 patients being fed in the UK in the community on enteral tube feeding using a variety of different feeding tubes (Percutaneous endoscopic gastrostomy (PEG), Jejunostomy, or nasogastric (NG). The majority of patients are over the age of 65 years when they had artificial feeding initiated and mainly because of dysphagia. The aim of this study was to explore GPs knowledge, attitudes and skills relating to enteral feeding in the community.MethodsSemi-structured one-to-one interviews with a convenience sample of GPs in Northern Ireland.ResultsTwenty-three GPs in three health boards in Northern Ireland participated in the study. Most found dealing with enteral feeding to be a predominantly negative experience. They had little involvement in patient selection for the procedure and poor or no discharge information. GPs felt inadequately trained, there was poor communication between primary and secondary care and little support. There was anger and frustration among GPs about lack of resources (funding and training), and the perception that primary care was used as a dumping ground.ConclusionMoving complex medical treatment from secondary to primary care has major implications for GPs who should be included in the patient selection process, have adequate discharge information about their patients, be adequately resourced and have appropriate support and training.

Facilitating patients' dietary change: A review of dietitians' correspondence practices with general practitioners

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Home enteral nutrition recipients: patient perspectives on training, complications and satisfaction

“…Previously, general practitioners have reported a lack of knowledge, poor communication between primary and secondary care and an unsatisfactory experience when dealing with HEN 13. Patients and their families have reported poor support from primary care providers 8…”

Evolução antropométrica e sintomas gastrointestinais em pacientes que receberam suplementos nutricionais ou nutrição enteral

“…Mesmo cientes das necessidades nutricionais bási-cas, a equipe de saúde pode supervalorizar as complicações da nutrição enteral e projetar sentimentos negativos diante de paciente em privados da alimentação por via oral 27,28 . Embora a suplementação nutricional possa beneficiar muitos indivíduos, os dados obtidos no presente estudo não evidenciam o benefício da suplementação nutricional de rotina para pacientes hospitalizados.…”