Bolstering General Practitioner Palliative Care: A Critical Review of Support Provided by Australian Guidelines for Life-Limiting Chronic Conditions

Abstract

General practitioners (GPs) are increasingly expected to provide palliative care as ageing populations put pressure on specialist services. Some GPs, however, cite barriers to providing this care including prognostication challenges and lack of confidence. Palliative care content within clinical practice guidelines might serve as an opportunistic source of informational support to GPs. This review analysed palliative care content within Australian guidelines for life-limiting conditions to determine the extent to which it might satisfy GPs’ stated information needs and support them to provide quality end-of-life care. Six databases and guideline repositories were searched (2011–2018). Eligible guidelines were those for a GP audience and explicitly based on an appraisal of all available evidence. Content was mapped against an established palliative care domain framework (PEPSI-COLA) and quality was assessed using AGREE-II. The nine guidelines meeting inclusion criteria were heterogenous in scope and depth of palliative care domain coverage. The ‘communication’ needs domain was best addressed while patient physical and emotional needs were variably covered. Spiritual, out-of-hours, terminal care and aftercare content was scant. Few guidelines addressed areas GPs are known to find challenging or acknowledged useful decision-support tools. A template covering important domains might reduce content variability across guidelines.

The palliative care in Australia and Canada

“…Należy podkreślić, że udzielanie takiej pomocy nie jest proste oraz wzbudza wiele obaw wśród lekarzy nie będących specjalistami w tej dziedzinie [10]. Adresowane do nich wytyczne są niespójne i nie zawierają konkretnych i kompleksowych informacji na temat opieki paliatywnej [11], dlatego bardzo istotne jest wcześniejsze przygotowanie personelu medycznego [10].…”

Benefits of Structured Engagement with Target Audiences of a Health Website: Study Design for a Multi-Case Study (Preprint)

“…Palliative care is an area of increasing importance to communities, policy makers and the health system given an ageing population, increasing care complexity relating to disease burden and comorbidities, and the diversity of individual needs of people who are at the end of their life [3,4]. The Australian Government Department of Health has developed a National Palliative Care Strategy and has funded a set of national palliative care projects to improve palliative care awareness and provision across Australia [1,5].…”

“…at the end of their life [3,4]. The Australian Government Department of Health has dev oped a National Palliative Care Strategy and has funded a set of national palliative c projects to improve palliative care awareness and provision across Australia [1,5].…”