Palliative care consultations in primary care: a cross-sectional survey among Dutch general practitioners.
BACKGROUND
Expert consultation supports general practitioners (GPs) in delivering adequate palliative homecare. Insight into consultation practices from a GP's perspective is needed in order to shape consultation services to their wishes and needs.


OBJECTIVE
To explore palliative care consultation practices from a GP's perspective.


METHODS
Cross-sectional web-based survey among all GPs (n=235) in the region of Nijmegen, the Netherlands.


METHODS
Our questionnaire contained questions about the delivery of palliative care by GPs, their consultation practices and satisfaction with current services. Questions consisted mainly of 5-point Likert scales. We transformed these scales into numerical values to calculate mean scores. Linear mixed models for repeated measurements were used to study differences in scores.


RESULTS
GPs most often consulted informal caregivers (mean score 3.6) or fellow GPs (mean score 3.3). Physical problems were discussed the most (mean score 3.5), while social and existential issues were discussed least (mean score 1.9 for both). In their choice of a particular consultation service, GPs considered the quality of the provided advice to be the most important factor. GPs were satisfied with current consultation services, with fellow GPs receiving the highest satisfaction scores (mean score 4.6). Finally, when recalling their last palliative patient, most GPs started requesting consultation during this patient's last month of life.


CONCLUSIONS
Next to informal caregivers, GPs preferably seek advice from fellow GPs. Physical issues receive much attention during consultations; however, other vital aspects of palliative care seem to remain relatively neglected, such as social and existential issues and a proactive care approach.
Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
Patrick D
PD
Hoek
Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands.
Henk J
HJ
Schers
Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands.
Jan C M
JCM
Hendriks
Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
Kris C P
KCP
Vissers
Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
Jeroen G J
JGJ
Hasselaar
D000328:Adult; D001291:Attitude of Health Personnel; D017028:Caregivers; D003430:Cross-Sectional Studies; D005260:Female; D058005:General Practitioners / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010166:Palliative Care / Q000379:methods / Q000523:psychology* / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000379:methods* / Q000706:statistics & numerical data; D012017:Referral and Consultation; D011795:Surveys and Questionnaires
Consultation; General practice; Palliative Care; Primary care