The family physician’s role in palliative care: Views and experiences of patients with cancer

Abstract

Background: Family physicians (FPs) are a vital component of palliative care, yet little is known about how patients understand their FP’s role in palliative care. Aims: This study aimed to explore patients’ views and experiences of: 1. The FP’s role in providing palliative care to patients with cancer 2. The facilitators and barriers to the FP’s ability to fulfil this perceived role. Methods: Qualitative semi-structured interviews, with adults with a cancer diagnosis known to an inner-city hospice in England, were undertaken. Thematic and discourse analysis were applied. Results: Fifteen participants reported their perceptions of the FP’s role in palliative care: prescription management; home visits; care coordination; and emotional support. Observed facilitators and barriers to good FP palliative care were identified: accessibility to FP; continuity of care; FP’s attitude and interpersonal skills; time and staffing levels; FP’s involvement in diagnosis; and communication between primary and secondary care. Conclusion: Accessibility and continuity were highlighted as key challenges within FP palliative care. The broadening responsibilities and competitive pressures facing FPs may undermine their capacity to effectively deliver palliative care. Further research is required to determine optimal models of FP palliative care provision.

Keywords:

• Palliative Care
• Cancer
• Primary Care
• Physicians, General Practice
• Family
• Physicians, Family

Acknowledgements

The authors would like to thank the participants who gave their time to share their experiences and the hospice team for their assistance with the R&D approval process and recruitment.

Disclaimer statements

Contributions EC: study design, patient and public involvement, data collection, transcription, data analysis, manuscript writing, submission to journal; HL: support with study design and ethical approval process, supervision of data analysis, manuscript editing; PW: overall study supervision, manuscript editing; JN: recruitment coordination, manuscript comments.

Funding The study was sponsored by King’s College London and was supported financially by EC’s Academic Clinical Fellowship funded by Health Education England.

Conflicts of interest The authors declare not to have any conflict of interest.

Ethical approval The study was approved on 18 September 2017 by the Brent Research Ethics Committee (IRAS ID 225027). Research and Development approval from the hospice team was gained on 2 November 2017 (ID STJHR082).

ORCID

Heidi Lempp http://orcid.org/0000-0003-2509-3656