End-of-life care in general practice: clinic-based data collection

It is known that routine data collection of health services, combined with feedback on clinical performance can improve care management. Yet, there are currently no processes that routinely assess end-of-life care in Australian general practice. Through systematic reviews, stakeholder’s opinions and a rigorous expert review process, this study developed a data collection process for end-of-life care from Australian general practitioners (GPs). This consisted of three questionnaires: Basic Practice Descriptors, Clinical Data Query, GP-completed questionnaire, as well as data extraction from general practice software. The feasibility and acceptability of the data collection method was subsequently evaluated through interviews with 23 GPs. With regards to time, most GPs did not consider the questionnaire to be overly time consuming, however a minority found it to be laborious. Furthermore, many GPs reported difficulties in recalling the medications and investigations for the patient in the last year of life, particularly if they only cared for the patient for a short time. More so, unclear or inappropriate wording for some questions resulted in confusion and misinterpretation. That being said, the majority of GPs found the questionnaires straightforward overall. This study has developed a feasible and acceptable data collection process, and these findings will contribute to bridging the knowledge gap in end-of-life care in Australian general practice. Going forth, future studies could develop an automated data extraction tool to reduce recall burden for GPs. 

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