Screening Protocols for Identifying Palliative Care Needs in Primary Care: A Scoping Review

Early identification of palliative care needs in primary care is increasingly recognized as essential, yet the implementation of screening tools remains inconsistent and challenging.

To identify the implementation of screening tool protocols in primary care for early identification of patients with palliative care needs, and to describe enablers or barriers influencing their uptake and integration into routine practice. This review also sought to map the methodologies, theoretical frameworks, and screening measures employed.

This scoping review was guided by the Arksey and O'Malley framework. Literature was retrieved from the MEDLINE, CINAHL, Scopus, and Cochrane databases, focusing on screening tools for early identification of palliative care needs in primary care. Articles published in English between January 2015 and March 2025 were included. The Consolidated Framework for Implementation Research (CIFR) was used as an overarching categorizing structure for synthesizing the identified barriers and facilitators.

A total of 3,140 articles were identified, and 174 were included for full-text screening. In total, 25 studies were included in the review. The implemented tools varied in their application and integration within primary care settings. Key barriers to implementing palliative care screening protocols in primary care included time constraints, doubts about the tool's value, limited resources, poor communication, unfavorable funding models, and sociocultural attitudes toward palliative care. Facilitators included integration with electronic health records, the presence of clinical champions, early reframing of palliative care, clearly defined roles, and tailored training initiatives.

Implementation of screening tools in primary care remains challenging due to contextual, organizational, and individual-level factors. Successfully embedding these tools into practice requires tailored context-sensitive strategies that are co-designed with interprofessional communication and informed by the principles of implementation science.