Palliative care referral practices and perceptions: The divide between metropolitan and non-metropolitan general practitioners

Johnson, CE; Girgis, A; Paul, CL; Currow, DC

Palliative care referral practices and perceptions: The divide between metropolitan and non-metropolitan general practitioners

Johnson, CE

Girgis, A Paul, CL Currow, DC

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Publication Type:: Journal Article
Citation:: Palliative and Supportive Care, 2011, 9 (2), pp. 181 - 189
Issue Date:: 2011-06-01

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Field	Value	Language
dc.contributor.author	Johnson, CE https://orcid.org/0000-0001-9190-8441	en_US
dc.contributor.author	Girgis, A	en_US
dc.contributor.author	Paul, CL	en_US
dc.contributor.author	Currow, DC https://orcid.org/0000-0003-1988-1250	en_US
dc.date.issued	2011-06-01	en_US
dc.identifier.citation	Palliative and Supportive Care, 2011, 9 (2), pp. 181 - 189	en_US
dc.identifier.issn	1478-9515	en_US
dc.identifier.uri	http://hdl.handle.net/10453/118242
dc.description.abstract	Objective: Late or non-referral of patients to specialist palliative care (SPC) services may affect patients' and their carers' quality of care. General practitioners (GPs) are key professionals in linking people with SPC. The aim of this article is to assess GPs' perceptions and SPC referrals for their patients with advanced cancer and differences between metropolitan (M GPs) and non-metropolitan GPs (NM GPs). Method: Self-report survey mailed to a stratified random sample of 1,680 Australian GPs was used. Results: Thirty-one percent (469) of eligible GPs returned surveys. More M GPs than NM GPs reported referring >60% of their patients for SPC (p=0.014); and that a more comprehensive range of SPC services was available. The most frequently reported referral prompts were: presence of terminal illness (M GPs, 71%, NM GPs, 66%, ns (not significant)); future need for symptom control (69% vs. 59%, ns) and uncontrolled physical symptoms (63% vs. 54%, ns). Reasons for not referring were: doctor's ability to manage symptoms (62% vs. 68%, ns) and the absence of symptoms (29% vs. 18%, p=0.025). Higher referral was associated with: having a palliative care physician or consultative service available; agreeing that all patients with advanced cancer should be referred, and agreeing that with SPC, the needs of the family are better met.Significance of results: Referrals for SPC were primarily disease-related rather than for psychological and emotional concerns. Measures are needed to encourage referrals based upon psychosocial needs as well as for physical concerns, and to support GPs caring for people with advanced cancer in areas with fewer comprehensive SPC services. © 2011 Cambridge University Press.	en_US
dc.relation.ispartof	Palliative and Supportive Care	en_US
dc.relation.isbasedon	10.1017/S1478951511000058	en_US
dc.subject.classification	Oncology & Carcinogenesis	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Neoplasms	en_US
dc.subject.mesh	Palliative Care	en_US
dc.subject.mesh	Health Care Surveys	en_US
dc.subject.mesh	Attitude of Health Personnel	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Terminally Ill	en_US
dc.subject.mesh	Rural Health Services	en_US
dc.subject.mesh	Urban Health Services	en_US
dc.subject.mesh	Referral and Consultation	en_US
dc.subject.mesh	Health Services Accessibility	en_US
dc.subject.mesh	Physician's Practice Patterns	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	General Practitioners	en_US
dc.subject.mesh	Practice Patterns, Physicians'	en_US
dc.title	Palliative care referral practices and perceptions: The divide between metropolitan and non-metropolitan general practitioners	en_US
dc.type	Journal Article
utslib.citation.volume	2	en_US
utslib.citation.volume	9	en_US
utslib.for	1117 Public Health and Health Services	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/DVC (Teaching and Learning)
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	closed_access
pubs.issue	2	en_US
pubs.publication-status	Published	en_US
pubs.volume	9	en_US

Abstract:

Objective: Late or non-referral of patients to specialist palliative care (SPC) services may affect patients' and their carers' quality of care. General practitioners (GPs) are key professionals in linking people with SPC. The aim of this article is to assess GPs' perceptions and SPC referrals for their patients with advanced cancer and differences between metropolitan (M GPs) and non-metropolitan GPs (NM GPs). Method: Self-report survey mailed to a stratified random sample of 1,680 Australian GPs was used. Results: Thirty-one percent (469) of eligible GPs returned surveys. More M GPs than NM GPs reported referring >60% of their patients for SPC (p=0.014); and that a more comprehensive range of SPC services was available. The most frequently reported referral prompts were: presence of terminal illness (M GPs, 71%, NM GPs, 66%, ns (not significant)); future need for symptom control (69% vs. 59%, ns) and uncontrolled physical symptoms (63% vs. 54%, ns). Reasons for not referring were: doctor's ability to manage symptoms (62% vs. 68%, ns) and the absence of symptoms (29% vs. 18%, p=0.025). Higher referral was associated with: having a palliative care physician or consultative service available; agreeing that all patients with advanced cancer should be referred, and agreeing that with SPC, the needs of the family are better met.Significance of results: Referrals for SPC were primarily disease-related rather than for psychological and emotional concerns. Measures are needed to encourage referrals based upon psychosocial needs as well as for physical concerns, and to support GPs caring for people with advanced cancer in areas with fewer comprehensive SPC services. © 2011 Cambridge University Press.

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http://hdl.handle.net/10453/118242