General practice nurses and physicians and end of life: a systematic review of models of care

As the population ages, general practitioners (GPs) and general practice nurses (GPNs) face increasing demands to provide palliative care (PC) or end-of-life care (EoLC). To maximise the impact of GPs and GPNs, the effect of different models of care that have been developed to support their practice of EoLC needs to be understood. Thus, this systematic review examined published models of EoLC that incorporate or support GP and GPN practice, and their impact on patients, families and the health system. The results showed that services and guidelines for clinical issues have mixed impact on improving symptoms however, resulted in improved adherence to clinical guidelines. Furthermore, national frameworks facilitated patients being able to die in their preferred place. Additionally, GP-PC case conferences to plan and monitor a patients’care reduced hospitalizations, better maintained functional capacity and improved quality of life parameters in both patients with cancer and without cancer. These results demonstrate that primary care practitioners have a role in EoLC as patient and health system outcomes improve with their involvement. In future, more work is required on the role of GPNs and how to support them in this role.

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