General practitioner advance care planning knowledge and attitudes: ACP-GP cluster-randomised controlled trial

Area of Science:

• Medical Education
• Palliative Care
• Health Services Research

Background:

• Advance care planning (ACP) is crucial for aligning future medical care with patient values.
• General practitioners (GPs) play a vital role in facilitating ACP conversations.
• GPs' existing knowledge and attitudes towards ACP can present barriers to effective implementation.

Purpose of the Study:

• To evaluate the impact of the ACP-GP intervention on GPs' knowledge and attitudes concerning advance care planning.
• To assess whether a complex intervention improves GPs' capacity to conduct ACP discussions.

Main Methods:

• A phase-III cluster-randomised controlled trial involving 35 Belgian GPs.
• Intervention included GP training, ACP conversations, patient workbooks, and documentation templates.
• GPs' knowledge and attitudes were measured using the Next Steps questionnaire at baseline and 3, 6 months post-intervention.

Main Results:

• The ACP-GP intervention demonstrated no statistically significant effect on GPs' knowledge.
• No significant improvement was observed in GPs' attitudes towards ACP compared to the control group.
• Statistical analyses (Generalised estimating equations) did not reveal intervention benefits.

Conclusions:

• The ACP-GP intervention failed to enhance GPs' knowledge and attitudes regarding ACP.
• A potential ceiling effect, indicated by high baseline scores, might have obscured intervention effects.
• Future research may require refined assessment tools to accurately identify and address barriers in ACP.