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Many people in Scotland now benefit from anticipatory care before they die: an after death analysis and interviews with general practitioners

Journal Article


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Abstract


  • Background Key Information Summaries (KIS)

    were introduced throughout Scotland in 2013 so

    that anticipatory care plans written by general

    practitioners (GPs) could be routinely shared

    electronically and updated in real time, between

    GPs and providers of unscheduled and secondary

    care.

    Aims We aimed to describe the current reach of

    anticipatory and palliative care, and to explore

    GPs’ views on using KIS.

    Methods We studied the primary care records

    of all patients who died in 2014 in 9 diverse

    Lothian practices. We identified if anticipatory or

    palliative care had been started, and if so how

    many weeks before death and which aspects of

    care had been documented. We interviewed 10

    GPs to understand barriers and facilitating

    factors.

    Results Overall, 60% of patients were identified

    for a KIS, a median of 18 weeks before death.

    The numbers identified were highest for patients

    with cancer, with 75% identified compared with

    66% of those dying with dementia/frailty and

    only 41% dying from organ failure. Patients

    were more likely to die outside hospital if they

    had a KIS. GPs identified professional, patient

    and societal challenges in identifying patients for

    palliative care, especially those with non-cancer

    diagnoses.

    Conclusions GPs are identifying patients for

    anticipatory and palliative care more equitably

    across the different disease trajectories and

    earlier in the disease process than they were

    previously identifying patients specifically for

    palliative care. However, many patients still lack

    care planning, particularly those dying with

    organ failure.

UOW Authors


  •   Tapsfield, Julia (external author)
  •   Hall, Charlie (external author)
  •   Lunan, Carey (external author)
  •   McCutcheon, Hazel (external author)
  •   McLoughlin, Peter (external author)
  •   Rhee, Joel
  •   Leiva, Alfonso (external author)
  •   Spiller, Juliet (external author)
  •   Finucane, Anne (external author)
  •   Murray, Scott (external author)

Publication Date


  • 2016

Citation


  • Tapsfield, J., Hall, C., Lunan, C., McCutcheon, H., McLoughlin, P., Rhee, J., Leiva, A., Spiller, J., Finucane, A. & Murray, S. A. (2016). Many people in Scotland now benefit from anticipatory care before they die: an after death analysis and interviews with general practitioners. BMJ Supportive and Palliative Care, Online First 1-10.

Scopus Eid


  • 2-s2.0-85076108305

Ro Full-text Url


  • http://ro.uow.edu.au/cgi/viewcontent.cgi?article=6529&context=smhpapers

Ro Metadata Url


  • http://ro.uow.edu.au/smhpapers/5464

Number Of Pages


  • 9

Start Page


  • 1

End Page


  • 10

Volume


  • Online First

Place Of Publication


  • United Kingdom

Abstract


  • Background Key Information Summaries (KIS)

    were introduced throughout Scotland in 2013 so

    that anticipatory care plans written by general

    practitioners (GPs) could be routinely shared

    electronically and updated in real time, between

    GPs and providers of unscheduled and secondary

    care.

    Aims We aimed to describe the current reach of

    anticipatory and palliative care, and to explore

    GPs’ views on using KIS.

    Methods We studied the primary care records

    of all patients who died in 2014 in 9 diverse

    Lothian practices. We identified if anticipatory or

    palliative care had been started, and if so how

    many weeks before death and which aspects of

    care had been documented. We interviewed 10

    GPs to understand barriers and facilitating

    factors.

    Results Overall, 60% of patients were identified

    for a KIS, a median of 18 weeks before death.

    The numbers identified were highest for patients

    with cancer, with 75% identified compared with

    66% of those dying with dementia/frailty and

    only 41% dying from organ failure. Patients

    were more likely to die outside hospital if they

    had a KIS. GPs identified professional, patient

    and societal challenges in identifying patients for

    palliative care, especially those with non-cancer

    diagnoses.

    Conclusions GPs are identifying patients for

    anticipatory and palliative care more equitably

    across the different disease trajectories and

    earlier in the disease process than they were

    previously identifying patients specifically for

    palliative care. However, many patients still lack

    care planning, particularly those dying with

    organ failure.

UOW Authors


  •   Tapsfield, Julia (external author)
  •   Hall, Charlie (external author)
  •   Lunan, Carey (external author)
  •   McCutcheon, Hazel (external author)
  •   McLoughlin, Peter (external author)
  •   Rhee, Joel
  •   Leiva, Alfonso (external author)
  •   Spiller, Juliet (external author)
  •   Finucane, Anne (external author)
  •   Murray, Scott (external author)

Publication Date


  • 2016

Citation


  • Tapsfield, J., Hall, C., Lunan, C., McCutcheon, H., McLoughlin, P., Rhee, J., Leiva, A., Spiller, J., Finucane, A. & Murray, S. A. (2016). Many people in Scotland now benefit from anticipatory care before they die: an after death analysis and interviews with general practitioners. BMJ Supportive and Palliative Care, Online First 1-10.

Scopus Eid


  • 2-s2.0-85076108305

Ro Full-text Url


  • http://ro.uow.edu.au/cgi/viewcontent.cgi?article=6529&context=smhpapers

Ro Metadata Url


  • http://ro.uow.edu.au/smhpapers/5464

Number Of Pages


  • 9

Start Page


  • 1

End Page


  • 10

Volume


  • Online First

Place Of Publication


  • United Kingdom