Knowledge and Attitude of Primary Care Physicians towards Palliative Care. Is it time for integration?

Abstract

Background Although the primary care physicians’ role in delivering the majority of care with high-quality service for patients under palliative care is unquestionable, it is not clear what their current level of knowledge and attitude toward palliative care is. Aim To recognize the primary care physicians’ knowledge and attitude toward palliative care in Kuwait. Design and Setting: National survey using stratified random sampling was performed. A total of 25 primary care clinics in Kuwait were selected and 284 primary care physicians were recruited. Method: Palliative Care Attitude and Knowledge questionnaire (PCAK) were distributed to them. Their attitude and knowledge were measured. predictors of better attitude were assessed. Results The response rate was 79.2%(n = 225). 53.3%(n = 120) of primary care physicians had an uncertain attitude towards palliative care while only 15(6.7%) had good knowledge. Only 5.7% and 25.5% reported excellent or very good experience in the management of pain and other symptoms respectively. Moreover, 141(62.7%) and 119(52.9%) were not familiar with palliative care services in their community or length and types of coverage under palliative care benefits. Less than 50% responded correctly to the questions regarding the proper management of catastrophic bleeding, opioid initiation, types, toxicity and its role in refractory dyspnea. Higher knowledge score was a positive predictor for more positive attitude scores (OR:1.088, 95% CI: 1.012–1.170,P value: 0.023). Conclusion The majority of primary care physicians had uncertain attitude and poor knowledge towards palliative care. Integrating palliative care into primary health care systems is urgently needed to alleviate the suffering of those patients.