Associations between successful palliative trajectories, place of death and GP involvement

Abstract

Objective. General practitioner (GP) involvement may be instrumental in obtaining successful palliative cancer trajectories. The aim of the study was to examine associations between bereaved relatives’ evaluation of palliative cancer trajectories, place of death, and GP involvement. Design. Population-based, cross-sectional combined register and questionnaire study. Setting. The former Aarhus County, Denmark. Subjects. Questionnaire data on GPs’ palliative efforts and relatives’ evaluations of the palliative trajectories were obtained for 153 cases of deceased cancer patients. Main outcome measures. A successful palliative trajectory as evaluated retrospectively by the relatives. Results. Successful palliative trajectories were statistically significantly associated with home death (PR 1.48 (95% CI 1.04; 2.12)). No significant associations were identified between the evaluations of the palliative trajectory at home and GP involvement. “Relative living with patient” (PR 1.75 (95% CI: 0.87; 3.53)) and “GP having contact with relatives” (PR 1.69 (95% CI 0.55; 5.19)) were not significantly associated, but this may be due to the poor number of cases included in the final analysis. Conclusion. This study indicates that home death is positively associated with a higher likelihood that bereaved relatives will evaluate the palliative trajectory at home as successful. No specific GP services that were statistically significantly associated with higher satisfaction among relatives could be identified, but contact between GPs and relatives seems important and the impact needs further investigation.

Key Words::

• Denmark
• family practice
• neoplasm
• palliative care
• primary health care
• terminally ill

Acknowledgements

The authors would like to extend their thanks to the bereaved relatives and the GPs participating in this study.

Funding

The study was funded by the Aarhus County Research Fund for Clinical Development and Research in General Practice and across the Primary and Secondary Health Care Sectors (4-01-3-04), the Danish National Research Foundation for Primary Care (585-457808) and the Multipractice Study Committee (585-04/2072).

Ethical approvals

According to the Regional Research Ethics Committee, the Biomedical Research Ethics Committee System Act does not apply to this study as no active intervention was involved. The study was approved by the Danish Data Protection Agency and the Danish National Board of Health.

Conflicts of interest:

The authors have no conflicts of interest.