Investigators
Slort W, MD
Schweitzer BPM, MD
Blankenstein AH, MD PhD
Abarshi EA MD
Riphagen II
Echteld MA PhD
Aaronson NK PhD
Van der Horst HE MD
Deliens L PhD
Overview
Context. While effective communication between GPs and
their palliative care patients is considered to be an essential
requirement in the provision of good care, it is still unclear what
the most important barriers and facilitators are for GP-patient
communication in palliative care.
Objectives. The study objectives were to identify barriers and
facilitators for GP-patient communication in palliative care.
Methods. A systematic literature review of published empirical studies focusing on GP-patient communication in palliative care. Relevant computerized databases were searched for eligible studies: Embase, PubMed , PsycINFO, CINAHL, and CDSR, DARE, and CENTRAL in the Cochrane Library.
Results. Fifteen qualitative studies and seven quantitative studies based on questionnaires were included. The identified barriers included the GP’s lack of time, the patient’s ambivalence with regard to the actual prognosis, and GPs not talking honestly about diagnosis and prognosis. The identified facilitators included the availability of the GPs, GPs taking the necessary time, showing commitment, being open, honest and friendly, listening actively, taking the initiative to talk about end-of-life issues, and anticipating various scenarios.
Conclusion. We identified structural and process barriers and facilitators for GP-patient communication in palliative care. Three main categories of factors influencing GP-patient communication in palliative care emerged from our review: the availability of the GP, the GP taking the initiative to talk about several actual topics, and anticipating various scenarios. The results of this review can contribute to the development of quality indicators for GP-patient communication in palliative care.