title: Low confidence among general practitioners in end-of-life care and subcutaneous administration of medicine.
abstract: BACKGROUND
  Most terminally ill patients prefer to die at home, and the general practitioner (GP) is central in making this possible. However, knowledge is needed about the GP's level of confidence in assuming this task and with subcutaneous (SC) administration of medicine in end-of-life care. The aim of this study was to determine if GPs used SC needle and medication in end-of-life care, if they felt confident about being principally responsible for palliative trajectories and whether such confidence was associated with GP characteristics.
  
  
  METHODS
  This was a cross-sectional questionnaire survey of all 332 GPs practising in Copenhagen, Denmark. Questions covered the GPs' use of SC medication/needle and their confidence in being principally responsible for palliative trajectories.
  
  
  RESULTS
  The survey response rate was 61%. 43% of the respondents had been principally responsible for a minimum of one palliative trajectory, and only 11% of these GPs had used a SC needle during this process. 57% felt very or somewhat confident being principally responsible and 27% felt very or somewhat confident administrating SC medicine. Confidence as principally responsible was positively associated with the number of palliative trajectories for which the GP had been responsible, but no significant associations with the GPs' age, gender or practice organisation were found.
  
  
  CONCLUSIONS
  We found that few GPs in Copenhagen feel very confident about being responsible for terminal care and that very few used SC needles. Hence, more education and training in this field is warranted. Further research is needed into how GPs may best become involved and supported in end-of-life care.
  
  
  BACKGROUND
  Danish General Practitioners' Educational and Development Fund.
  
  
  BACKGROUND
  not relevant.
authors.affiliation: gorlen@dadlnet.dk
authors.forename: Thomas
authors.initials: T
authors.lastname: Gorlén
authors.forename: Tanja Fromberg
authors.initials: TF
authors.lastname: Gorlén
authors.forename: Mikkel
authors.initials: M
authors.lastname: Vass
authors.forename: Mette Asbjørn
authors.initials: MA
authors.lastname: Neergaard
mesh_terms: D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use; D002983:Clinical Competence; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003718:Denmark; D005260:Female; D058005:General Practitioners / Q000523:psychology* / Q000706:statistics & numerical data; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006699:Home Care Services; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy; D012649:Self Concept; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000523:psychology* / Q000706:statistics & numerical data
chemical_list: D000700:Analgesics