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Improving primary palliative care - a Delphi consensus study on measures for general practice in Germany.
Esma Sümeyya Bilgin1, Rojda Ülgüt1, Nils Schneider1
1Institute for General Practice, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
BMC Primary Care
|February 17, 2022
Summary
General practitioners can provide primary palliative care (PPC) to dying patients in Germany. A Delphi study identified 20 practical measures to help integrate PPC into daily GP practice, focusing on patient care, communication, and practice organization.
Area of Science:
- Palliative Care
- General Practice
- Healthcare Delivery
Background:
- General practitioners (GPs) are key to providing primary palliative care (PPC) for terminally ill patients in Germany.
- Current PPC provision by GPs does not meet population needs.
- Integrating PPC into daily GP routines remains a challenge despite public health initiatives.
Purpose of the Study:
- To achieve consensus among GPs on specific measures for improving PPC integration into routine practice.
- To develop and evaluate practical measures for enhancing PPC delivery in general practices.
Main Methods:
- A Delphi consensus study involving 569 GPs was conducted.
- GPs rated the relevance and feasibility of 26 practical measures via an online questionnaire.
- Consensus was defined as ≥75% agreement after two rounds, with measure adaptation based on feedback.
Main Results:
- Twenty out of 26 measures achieved consensus.
- Consented measures cover advance care planning, patient/caregiver communication, practice organization, and continuing education.
- Six measures were not consented, primarily due to time and workload constraints.
Conclusions:
- The 20 consented measures offer practical support for GPs to enhance PPC provision.
- These measures are flexible and suitable for nationwide implementation in GP practices.
- The findings can help improve the quality and accessibility of primary palliative care.
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