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  • Systematic review of the effectiveness, barriers and facilitators to general practitioner engagement with specialist secondary services in integrated palliative care

    Author(s)
    Carmont, Sue-Ann
    Mitchell, Geoffrey
    Senior, Hugh
    Foster, Michele
    Griffith University Author(s)
    Foster, Michele M.
    Year published
    2018
    Metadata
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    Abstract
    The general practitioner (GP) has a critical role in an integrated model of palliative care as they often know the patient and carer well, are experts in generalist care and have knowledge of health and social services in the community. Specialist palliative services have insufficient capacity to meet demand and those with non-cancer terminal conditions and those from rural and remote areas are underserved. Research has focused on improving access to palliative care by engaging the GP with specialist secondary services in integrated palliative care. Objectives: (1) Evaluate the effectiveness of interventions designed to ...
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    The general practitioner (GP) has a critical role in an integrated model of palliative care as they often know the patient and carer well, are experts in generalist care and have knowledge of health and social services in the community. Specialist palliative services have insufficient capacity to meet demand and those with non-cancer terminal conditions and those from rural and remote areas are underserved. Research has focused on improving access to palliative care by engaging the GP with specialist secondary services in integrated palliative care. Objectives: (1) Evaluate the effectiveness of interventions designed to engage GPs and specialist secondary services in integrated palliative care; and (2) identify the personal, system and structural barriers and facilitators to integrated palliative care. Method: MEDLINE, EMBASE and CINAHL were searched. Any study of a service that engaged the GP with specialist secondary services in the provision of palliative care was included. GP engagement was defined as any organised cooperation between the GP and specialist secondary services in the care of the patient including shared consultations, case conferences that involved at least both the GP and the specialist clinician and/or other secondary services, and/or any formal shared care arrangements between the GP and specialist services. The specialist secondary service is either a specialist palliative service or a service providing specialist care to a palliative population. A narrative framework was used to describe the findings. Results: 17 studies were included. There is some evidence that integrated palliative care can reduce hospitalisations and maintain functional status. There are substantial barriers to providing integrated care. Principles and facilitators of the provision of integrated palliative care are discussed. Conclusions: This is an emerging field and further research is required assessing the effectiveness of different models of integrated palliative care.
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    Journal Title
    BMJ Supportive & Palliative Care
    DOI
    https://doi.org/10.1136/bmjspcare-2016-001125
    Note
    This publication has been entered into Griffith Research Online as an Advanced Online Version.
    Subject
    Nursing
    Health services and systems
    Public health
    Publication URI
    http://hdl.handle.net/10072/377495
    Collection
    • Journal articles

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