Work

Meeting the Needs of Palliative Care Patients: General Practitioners' Survey on the Last Three Months of Life

Year: 2025

Type: article

Abstract: CONTEXT: Evaluating palliative care is challenging. Quality and efficiency indicators are not standardized, especially in primary care. OBJECTIVES: To assess the adequacy of care to the patients' needs and associated factors, during the last three months of life, for palliative care patients followed up in general practice. METHODS: A quantitative study based on a mortality follow-back survey of general practitioners (GPs), in metropolitan France. From November 2020 to November 2021, GPs included adult patients who died a predictable death. For each patient, they retrospectively rated how well the care provided met the patient's needs using a numerical scale. A generalized mixed model of logistic regression was used to examine associations between a positive evaluation and GP, patient, and care characteristics. RESULTS: Ninety-five GPs reported 295 patients. The median age was 85 years and 54% were women. The most common disease was cancer (41%) and 43% had dementia. Care assessment was mostly positive (76%). Cancer and hospitalization were negative factors (OR [95% CI] = 0.46 [0.25-0.86] and OR = 0.51 [0.26-0.98] respectively). Dementia, psychologist intervention and discussions with the family tended to be associated with positive evaluation but results were not significant due to a lack of statistical power (OR = 1.86 [0.98-3.52]; OR = 10.5 [2.12-51.8], OR = 2.74 [0.99-7.57] respectively). CONCLUSION: In end-of-life, GPs' evaluation of care adequacy to patient's needs was mostly positive. Indicators for palliative care evaluation, in a patient-centered approach, should consider inequalities due to medical conditions such as dementia and consider all the different possible care settings. Communication, psychosocial and spiritual approaches should be encouraged.

Source: Journal of Pain and Symptom Management

DOI: 10.1016/j.jpainsymman.2025.03.006