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Engagement of Primary Care Physicians in Home Palliative Care
Shiraz Malik1, Russell Goldman2,3, Nanor Kevork4
11 Department of Family Medicine, Western University and London Health Sciences Centre, London, Ontario, Canada.
Purpose:
To describe prevalence and characteristics associated with family physician and general practitioner (FP/GP) provision of home palliative care (HPC).
Methods:
We surveyed FP/GPs in an urban health region of Ontario, Canada, to determine their current involvement in HPC, the nature of services provided, and perceived barriers and enablers.
Results:
A total of 1439 surveys were mailed. Of the 302 FP/GP respondents, 295 provided replies regarding engagement in HPC: 101 of 295 (33%) provided HPC, 76 (26%) were engageable with further support, and 118 (40%) were not engageable regardless of support. The most substantial barrier was time to provide home visits (81%). Engaged FP/GPs were most likely to be working with another physician providing HPC ( P < .0001). Engageable FP/GPs were younger ( P = .007) and placed greater value on improved remuneration ( P < .001) than the other groups. Nonengageable physicians were most likely to view time as a barrier ( P < .0001) and to lack interest in PC ( P = .03).
Conclusion:
One-third of FP/GPs provide HPC. A cohort of younger physicians could be engageable with adequate support. Integrated practices including collaboration with specialist PC colleagues should be encouraged and supported.
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